Valve sparing root replacement: reimplantation of the aortic valve.

Aphram, Gaby [UCL] Tamer, Saadallah [UCL] Mastrobuoni, Stefano [UCL] El Khoury, Gebrine [UCL] de Kerchove, Laurent [UCL]

(eng) CLINICAL VIGNETTE : The first patient in the video is an asymptomatic 65-year-old male patient with permanent atrial fibrillation and permanent pacemaker for atrioventricular block of second degree. Transthoracic echocardiogram shows a tricuspid aortic valve (TAV) with eccentric aortic insufficiency (AI) grade 3+ towards the mitral valve indicating a right coronary leaflet prolapse. The left ventricular end diastolic (LVEDD) and end systolic (LVESD) diameter are 66 and 38 mm, respectively. The left ventricular ejection fraction (LVEF) is 72%. The ventriculoaortic junction (VAJ) diameter is 28 mm, the sinus of Valsalva is 45 mm, the sinotubular junction (STJ) is 40 mm and the ascending aorta is 42 mm. The second patient in the video is an asymptomatic 47-year-old male with no particular medical history. Transthoracic echocardiogram shows a bicuspid aortic valve (BAV) with right/left fusion, commissure orientation of 160° and eccentric AI grade 3+ towards the mitral valve indicating prolapse of the fused leaflet. The LVEDD and LVESD are 70 and 51 mm, respectively. The LVEF is 54%. The VAJ diameter is 30 mm, the sinus of Valsalva is 45 mm, the STJ is 36 mm and the ascending aorta is 40 mm.