OBJECTIVE: @entity1856 @entity449 ( @entity449 ) frequently present with @entity337 ( @entity337 ) from dilatation of the sino-tubular junction (STJ) and extension of the pathological process into the root. Experience suggests that root dilatation begins in the non-coronary, then right coronary sinus. Rather than employ aortic root replacement or the David procedure, we have elected to replace the ascending aorta and remodel the STJ and involved sinuses. We studied the outcome after selective sinus replacement in 29 consecutive @entity449 @entity1 between 1995 and 2001. METHODS: There were nine male and 20 females. Age ranged from 47 to 79 years (mean 67.5). Seven had arch @entity439 and four @entity453 . Nineteen were NYHA III or IV. Grade of @entity337 was IV in 20, III in five and II in four. The STJ was dilated >50% of annulus diameter in each case (5.3-10.0 cm, mean 6.4 cm). All valves had three cusps. All @entity1 underwent ascending aortic replacement. Seven had arch replacement and four coronary artery bypass. Seven had replacement of both right and non-coronary sinuses with re-implantation of the right coronary ostium. Twelve had replacement of the non-coronary sinus alone whilst nine had right coronary sinus replacement. One with @entity5512 had left coronary sinus replacement with ostial re-implantation. The graft size was within 2 mm of annulus size except for two @entity1 (24 mm 12, 26 mm 11, and 28 mm six). Post operative echocardiographic studies were performed. None of the patients received anticoagulation. RESULTS: There were no hospital or late deaths and no @entity1031 or infective complications. Two @entity1 had mild to moderate @entity337 . These had a size 28 graft, which in retrospect was too large. Others had no significant regurgitation. CONCLUSIONS: The native aortic valve can be preserved in the majority of @entity1 with @entity449 . Remodelling of the STJ and selective sinus replacement restores valve competence. Anticoagulation and prosthesis related complications are thereby avoided.

Aortic root remodeling in XXXX : the role of selected sinus repair.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity449 :: ('MESH:D001014', 'Disease') :: ['AAA', 'ascending aortic aneurysms'] @entity5512 :: ('MESH:D003914', 'Disease') :: ['dextrocardia'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity337 :: ('MESH:D001022', 'Disease') :: ['AR', 'aortic regurgitation'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic'] @entity1856 :: ('MESH:D058226', 'Disease') :: ['Atheromatous'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease']
@entity439 :: (MESH:D000783,Disease) :: ['atheromatous aneurysms']
