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Abstract
A number of patients who require an operation for complications of annuloaortic ectasia,
such as aortic incompetence or aneurysm of the aortic root (or both), have normal
aortic valve leaflets. We have treated these patients by excising the aneurysmal portion
of the ascending aorta and sinuses of Valsalva but by leaving the aortic valve leaflets
and some arterial wall attached to the left ventricular outflow tract. The aortic
valve is reimplanted inside a collagen-impregnated tubular Dacron graft, similar to
what is done for implantation of an aortic valve homograft. The coronary arteries
are also reimplanted. This operation was performed in 10 patients. All patients had
annuloaortic ectasia and five had the stigmata of Marfan syndrome. Four patients had
acute aortic dissection. There were no operative deaths, but one patient required
composite replacement of the aortic valve and ascending aorta because of persistent
aortic incompetence. Postoperative Doppler echocardiography revealed normal aortic
valve function in six patients and mild incompetence in three. The preliminary results
of this new operation are encouraging. Further investigation is necessary to establish
the best size, shape, and type of material that should be used to replace the aortic
root while preserving the aortic valve.