The aortic root is the part of the aorta that contains the aortic valve and the coronary arteries that supply blood flow to the heart. It marks the very beginning of the aorta.
The aortic root can be affected by either infection, natural laxity of the aortic tissue with enlargement over time, genetic syndromes that cause the root to enlarge, or even severe calcification of the aortic root.
The aortic root needs to be replaced when it is larger than a certain size—between 4.5 and 5.5 centimeters, depending on the patient and the presence of genetic deficiencies. Typically, your cardiologist will monitor your aortic root and let you know if you need surgery. Ask your cardiologist or surgeon if you have questions about the size or condition of your aortic root.
Our approach
We use the heart-lung machine during aortic root replacement. During the surgery, we look at the root and valve leaflets and remove the enlarged root as needed. We replace the root with a polyester synthetic graft material which stays indefinitely. The risk for infection or aneurysm caused by the graft is very low. During the root replacement, we remove the two main coronary arteries from their insertion points as buttons and then re-implant into the synthetic graft material.
Often during an aortic root surgery, the valve leaflets need to be replaced. If they do, your surgeon may use a biological valve or a mechanical valve. Sometimes, the aortic valve leaflet can be spared. This is especially true in patients with genetic syndromes who are younger and have an isolated enlargement of the root with normal valve leaflets. If a patient is a good candidate, the leaflets can be saved and re-suspended within the polyester graft material.
