A new patch technique for valve-sparing aortic root repair in acute type A aortic dissection

Valve-sparing aortic root replacement is an attractive option for younger patients with acute type A aortic dissection. This study aimed to design a new patch technique for reconstructing the aortic root and preserving the aortic valve following aortic dissection. Between July 2017 and December 2018, 35 patients underwent valve-sparing aortic root repair using this new patch technique. All participants were in the supine position, transesophageal echocardiography and median sternotomy were routinely performed. After thrombi at the aortic root were removed in acute type A dissection, the luminal aortic intimal dissection was removed until the aortic condition was normalized. In each aortic sinus involved in the dissection, a Dacron-graft patch with the shape corresponding to the defect was sutured to the normal remnant vascular wall or aortic annulus in the aortic sinus using 5-0 Prolene suture to reconstruct the aortic root. A total of 2 patients died, and 1 cerebral infarction, and 3 cases of transient brain dysfunction were recorded. The sinus tube junction and sinus diameter were within the normal ranges when they were reexamined 3 months after surgery. This new patch technique circumvents the redesign of the spatial 3D structure of the aortic valve, is simple to operate, and easy to master. It completely removes the diseased dissection tissue, avoids the use of glue, and is an alternative surgical technique, especially for beginners.

Automated summary

Valve-sparing aortic root replacement is a good option for younger patients with acute type A aortic dissection. A new patch technique was designed and successfully used in 35 patients to reconstruct the aortic root and preserve the aortic valve. The surgery is simple to operate and showed good results with normal sinus diameter 3 months post-operation.