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Reconstruction of Complex Proximal Aortic Dissections with Aortic Insufficiency Using Aortic Ring Annuloplasty

Tuesday, January 4, 2022

Perez-Tamayo A, Baker JN, Gerdisch MW, et al.. Reconstruction of Complex Proximal Aortic Dissections with Aortic Insufficiency Using Aortic Ring Annuloplasty. January 2022. doi:10.25373/ctsnet.17860808

Ascending aortic dissections often involve the aortic root and create aortic valve insufficiency. Prosthetic valve replacement in this setting yields inferior long-term results. Reparative management by commissural resuspension has been associated with an incidence of valve and sinus deterioration over time. This talk—first presented at the EACTS Aortic Forum in Bologna, Italy on November 15, 2021—provides background information on aortic ring annuloplasty and rationale for application to aortic root dissection, as well as video of a representative case with Loeyz-Dietz syndrome and extensive aortic root dissection. Using a combination of aortic ring annuloplasty to reestablish root geometry and aggressive remodeling replacement of involved sinuses, destroyed root structures and aortic competence routinely can be reestablished with a simple and safe approach. More cases and longer-term follow-up will be needed for full validation. 


References

  1. Rankin JS, Bone MC, Fries PM, Aicher D, Schafers HJ, Crooke PS. A refined hemispheric model of normal human aortic valve and root geometry. J Thorac Cardiovasc Surg. 2013;146:103-9.
  2. Rankin JS, Wei LM, Downey RS, Si M-S, Gerdisch MW, Kupferschmid JP, et al. Aortic Valve Repair Using Geometric Ring Annuloplasty. Operative Techniques in Thoracic and Cardiovascular Surgery. 2021;26:173-83.

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