Aortic root surgery is a procedure to treat an enlarged section (aneurysm) of the aorta. The aorta is the large blood vessel that carries blood from the heart to the body. The aortic root is located near where the aorta and the heart connect.
Why it's done
Doctors perform aortic root surgery to prevent a burst aneurysm. They also perform it to prevent a tear in the inner layer of the aorta's wall (aortic dissection). They also do it to prevent the enlarged aorta from stretching the attached aortic valve. Aortic aneurysms near the aortic root may be related to Marfan syndrome and other heart or inherited conditions.
How you prepare
Before aortic root surgery, your doctor may talk with you about the most appropriate treatment or surgery for your condition. Together, you will discuss surgery benefits and risks.
Your doctor will evaluate your risk of an aortic dissection. This is a tear in the inner layer of the wall of the large blood vessel that carries blood from the heart to the body (aorta).
Your doctor will likely also measure the aorta when deciding if aortic root surgery is best for you.
What you can expect
Ascending aortic root aneurysm repair and replacement
An ascending aortic root aneurysm procedure may be done in two ways. Valve-sparing aortic root repair (top right image) replaces the enlarged section of the aorta with an artificial tube (graft). The aortic valve stays in place. In aortic valve and aortic root replacement (bottom right image), the aortic valve and a part of the aorta are removed. A graft replaces the section of the aorta. A mechanical or biological valve replaces the valve.
There are several types of aortic root surgery, including:
- Aortic valve and root replacement. In aortic valve and root replacement (composite aortic root replacement), your surgeon removes a section of the body's largest blood vessel (aorta) your aortic valve. The section of your aorta is replaced with an artificial tube (graft), and your aortic valve is replaced with a mechanical or biological valve. If you have a mechanical valve, you'll need to take blood-thinning medications (anticoagulants) for life to prevent blood clots.
- Valve-sparing aortic root repair. In this procedure, the surgeon replaces the enlarged section of the aorta with a graft. The aortic valve stays in place. In one technique, your surgeon stitches the valve inside of the graft.
If you have some other heart conditions, your surgeon may perform additional procedures to treat these at the same time.
Aortic root surgery care at Mayo Clinic
July 30, 2021
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- Patlolla SH, et al. Outcomes and risk factors of late failure of valve-sparing aortic root replacement. Journal of Thoracic and Cardiovascular Surgery. 2020; doi:10.1016/j.jtcvs.2020.09.070.