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Ann Thorac Surg 2003;76:2099-2101
© 2003 The Society of Thoracic Surgeons

Case report

A modified valve-on-valve approach for aortic root replacement

Kazuhiro Kurisu, MD*a, Yoshie Ochiai, MDa, Takashi Kajiwara, MDa, Hiroshi Kumeda, MDa, Ryuji Tominaga, MDa

a Department of Cardiovascular Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan

Accepted for publication April 23, 2003.

* Address reprint requests to Dr Kurisu, Department of Cardiovascular Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu 802-0077, Japan
e-mail: sytkurisu{at}hkg.odn.ne.jp

We describe an alternative surgical technique for aortic root replacement in a patient whose aortic valve was previously replaced with a bioprosthesis. It consists of resecting the leaflets of the original bioprosthesis in situ, amputating the struts, and suturing the skirt of a composite graft on the preserved annulus of the original bioprosthesis. Coronary circulation is reconstructed according to the Cabrol modification. This approach simplifies and shortens the procedure of aortic root replacement, minimizing the potential hazard of hemorrhage from the proximal suture line in these cases.




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