JUAN CRESTANELLO: Imagine you're seeing a young patient with an aortic root aneurysm, tricuspid aortic valve, and connective tissue disorder. The patient is interested in knowing the outcomes and late results of valve-sparing aortic root surgery. This article will help to answer those questions. I am Dr. Juan Crestanello. Welcome to the Cardiovascular Surgery Series. I will discuss today the outcomes and risk factors of late failure of valve-sparing aortic root replacement.

We reviewed 342 patients who had valve-sparing root replacement at our clinic. Forty percent of the patients had a connective tissue disorder. The re-implantation technique was used in 90% of the patients. The operating mortality was 1%. Ninety-five percent of the patients had mild or less aortic regurgitation at the time of discharge. Severely dilated aortic annulus was a predictor of early failure.

Long-term survival was 84% at 10 years and 69% at 15 years. The probability of having severe aortic regurgitation at 10 years was just 8%. The rate of reoperation for aortic valve replacement was 17% at 15 years. Reoperations were for aortic regurgitation in 82% of the patients, and for aortic stenosis in 13%.

We conclude that valve-sparing aortic root replacement is an excellent option to treat patients with root aneurysms. It is associated with very low operative mortality, excellent long-term survival, and low rates of aortic valve replacement. Thank you for listening to the Cardiovascular Surgery Series.