Remodeling or Reimplantation for Valve-Sparing Aortic Root Surgery?

Armin W. Erasmi, Hans H. Sievers*, J. F.Matthias Bechtel, Thorsten Hanke, Ulrich Stierle, Martin Misfeld

*Corresponding author for this work
60 Citations (Scopus)


Background: Valve-sparing operations are gaining increasing acceptance; however, there is an ongoing discussion about the technique-specific indications. We present our experience with a follow-up of 123 months. Methods: Between July 1993 and July 2005, 164 consecutive patients were operated on using the remodeling (group A, n = 96) or reimplantation technique (group B, n = 68). Fifty-seven patients presented with acute type A dissection. Aortic regurgitation was present in 84%. Follow-up was 54.7 ± 28 in group A and 48.4 ± 37.3 months in group B. Results: After urgent operations, 4 patients died in each group, but none died after elective surgery. Late mortality was 8% in group A and 4% in group B. Seven patients of group A and 1 in group B required reoperation. Echocardiographic follow-up of reoperation-free survivors showed that 3 patients (all group A, 1.3%) had aortic regurgitation of more than grade II. Root diameter, valve pressure gradient, and valve orifice area were comparable. No gross thromboembolic or bleeding events occurred. Conclusions: Aortic valve-sparing operations can provide acceptable long-term results in both techniques. Particular care to the annulus in the remodeling technique and different prosthesis designs in the reimplantation technique may overcome the intrinsic problems of each procedure.

Original languageEnglish
JournalAnnals of Thoracic Surgery
Issue number2
Pages (from-to)S752-S756
Publication statusPublished - 02.2007


Dive into the research topics of 'Remodeling or Reimplantation for Valve-Sparing Aortic Root Surgery?'. Together they form a unique fingerprint.

Cite this