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Full Root Replacement with Stentless Valves Should Be More Frequently Performed

France

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Full root aortic replacement with a stentless tissue valve has been introduced over the past 15 years. At the start, this operation was considered complex surgery to be performed only by highly experienced surgeons used to homograft surgery. Today, various reasons lead us to revisit the role of the stentless valve in aortic surgery. The technique of full root replacement is now well standardized. After accurate sizing, a continuous running suture allows subannular implantation of the valve, without any technical problem, even in the case of an altered annulus (such as in redo surgery or highly calcified aortic stenosis). Implantation of the aortic buttons carrying the coronary ostia can be performed safely using Teflon or pericardial strips, or a double-layer suture technique (personal technique). Generally, the procedure can be performed reproducibly within 60–80 min, far within the safety period of myocardial ischemia using present cardioplegia techniques.¹ It can be concluded that there is no . . . [Full Text of this Article]