Aortic root remodeling with the "Cuff" technique for stentless valve implantation

Aortic root and sinotubular junction dilatation and aneurysm of ascending a orta are considered relative contraindications to implantation of a stentle ss valve prosthesis, because the modified aortic geometry leads to aortic i ncompetence and early failure of the prosthesis. Aortic root reconstruction can be performed according to various techniques. We present a surgical te chnique in which a tubular graft, replacing an ascending aortic aneurysm, a llows sinotubular remodeling and satisfactory implantation of a stentless p rosthesis. The native aorta is inserted into the vascular prosthesis at the level of the sinotubular junction which is wrapped in order to prevent com missure spreading. Sizing of the vascular and valve prosthesis is made acco rding to annular diameter. Since October 1999, 6 patients have been operate d using this technique with good results. (C) 2001 by The Society of Thorac ic Surgeons.