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How to Perform an Aortic Root Replacement

Monday, June 9, 2014

A step-by-step guide for performing an aortic root replacement with the Freestyle Aortic Root. Safeguards and pitfalls are reviewed.


Yes, Aristotle, this valve could have been repaired with root remodeling. This video was from quite a few years ago before I performed any David procedures. Thank you for an excellent question.
Thank you for the very didactic video. I have found the stay stitches on the top of the commissures, being placed in the very beginning, extremely useful. Two questions: 1. Will you use the interrupted stitches and pericardial strip when you implant a homograft or pulmonary autograft in the aortic root? 2. Do you always orientate the Free style root like this (RCA button to porcine RCA and LCA button posterior)? Thank you, George Belitsis, Senior Surgical Fellow, Royal Brompton and Harefield Trust, London
Thank you for your question, George. I use the exact same technique regardless of the root prosthesis used. As for the freestyle orientation in root replacements, I have not found it necessary in most circumstances to rotate the freestyle--usually the RCA button, once mobilized, reaches the freestyle RCA easily. However, if I am concerned about the right coronary button's mobility, I would not hesitate to rotate the valve so that the porcine RCA faces the patient's noncoronary sinus.

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