Cirugía conservadora de la válvula aórtica

Aortic valve-sparing surgery is part of the surgical armamentarium in cases of aortic valve incompetence and aneurysm of the ascending aorta. The reimplantation technique described initially by David and Feindel and the remodelling of aortic root first described by Yacoub, are indicated in case of valvular insufficiency due to outward displacement of the commissures in tricuspid aortic valves with structurally normal leaflets. In selected cases, they have partially replaced the gold standard approach of implantation of a mechanical valved aortic composite graft, with the drawback of lifelong anticoagulation. The excellent clinical results after ten years of experience have motivated the expansion of the indications to patients with cusp prolapse, bicuspid valves, Marfan syndrome and aortic dissections. This current review will be focused on the conservative surgery of the aortic root in cases of concomitant aortic insufficiency and aneurysms of the ascending aorta.