Aortic root reconstruction is a procedure to treat aortic aneurysm. An aneurysm is a condition characterised by an abnormal bulging or ballooning in the wall of a blood vessel. An aneurysm can develop anywhere along the course of the aorta. The aorta is the largest blood vessel in the body that carries oxygen rich blood from the left ventricle to the various parts of the body. The beginning of the aorta is called aortic root. It thus forms the bridge between the left ventricle and ascending aorta. The aortic root is the section of the aorta that includes the aortic valve and the openings for the coronary arteries.
Aneurysm at the aortic root is associated with Marfan syndrome and other heart conditions. Marfan syndrome is dilation (widening) of the aortic root. An aneurysm at the aortic root can cause the aortic valve to become stretched and leak. If left untreated, it may lead to a life threatening condition called aneurysm dissection resulting in aortic rupture.
Aortic root aneurysm can be treated by reconstruction of this delicate area surgically, through aortic root reconstruction. This involves complete resection of the diseased portion of the aorta including the aortic valve. The aortic root is then replaced with an artificial tube (graft) and aortic valve is replaced with a mechanical or biological valve. This type of aortic root reconstruction is called aortic root replacement. When a mechanical valve is chosen, lifelong anticoagulation therapy is required. When a biological valve is used, reoperation may be required should the biological valve fail.
Valve sparing aortic root repair is another alternate procedure for aortic root reconstruction that involves preservation of the patient’s own aortic valve. During this procedure the enlarged section of the aorta is replaced with an artificial tube (graft). The patient’s aortic valve stays in place, and is sutured to the inside of the graft. This stabilises the aortic annulus and prevents further aortic dilatation. It also enhances the durability of the native valve function.