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How To Do It

Transecting the Aorta to Close the Aortic Prosthetic Valve Paravalvular Space

^a Department of Cardiac Surgery, Institute for Cardiovascular Disease "DEDINJE," Belgrade, Serbia
^b Department of Anesthesiology, Institute for Cardiovascular Disease "DEDINJE," Belgrade, Serbia
^c Department of Cardiology, Institute for Cardiovascular Disease "DEDINJE," Belgrade, Serbia
^d Department of Gynecology, Clinical Center of Serbia, Belgrade, Serbia

Accepted for publication April 3, 2008.

^_* Address correspondence to Dr Stojanovic, IKVB "DEDINJE," H.M. Tepica 1, Belgrade, 11000, Serbia (Email: stojivan{at}eunet.yu).

The residual aortic prosthetic valve paravalvular space beneath the left coronary artery is very difficult and risky to repair. To improve visualization of this area, we transected the ascending aorta and mobilized both the aortic root and the left coronary artery from the surrounding tissue. Subsequently, we retracted the left coronary artery aside and pulled the posterior aortic root upwards. This maneuver has provided enough space for the safe placement of stitches and the closure of the paraprosthetic defect in this very delicate area.