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What is an Aortic Root Replacement?

An Aortic Root Replacement is a life-saving surgical procedure where the damaged section of the aorta near the heart is replaced with a synthetic graft. This intricate operation helps prevent aortic aneurysms or dissections, which can be fatal if left untreated. Intrigued by how this procedure could protect your heart health? Discover the visual journey of this transformative surgery.
H. Colledge
H. Colledge

Aortic root replacement is a type of surgery used to treat a swelling at the root of the body's biggest artery, known as the aorta. The aortic root is located at the top end of the aorta where it meets the heart. A swelling, or aneurysm, in the aorta is most often due to atherosclerosis, a condition where fatty deposits build up inside arteries, causing weakening of the walls. As a bulging aneurysm carries a risk of bursting, with possibly fatal consequences, aortic root surgery is performed to remove the damaged part of the aorta. A replacement section, made of artificial fabric or natural tissue, is then inserted instead.

There are two ways of carrying out aortic root replacement surgery. In what are known as valve-sparing aortic root replacement techniques, an important structure known as the aortic valve is left in place. Other root replacement methods replace both valve and root.

A diagram of the aorta, including the aortic root.
A diagram of the aorta, including the aortic root.

The aortic valve is situated in the root of the aorta where it regulates the blood flowing from the heart's left lower chamber, or ventricle. When blood is pumped out of the left ventricle, the aortic valve opens to allow it to pass through. Following the ejection of blood, the valve closes to prevent any blood leaking back into the heart.

Patients who have aortic root aneurysms, but whose aortic valves still function, may be treated using valve-sparing aortic root replacement. In what is called the David procedure, the damaged section of the aorta is removed, and a synthetic graft is attached to the heart in its place. The original aortic valve is sewn into position inside the graft. This type of cardiac surgery is what is referred to as open-heart surgery, where the chest is opened up and a machine acts as the heart and lungs, supplying the body with oxygenated blood while the heart is being operated on. It may require a hospital stay of about a week, and recovery may take up to six weeks.

When a bulging aneurysm has a risk of bursting, aortic root surgery is performed.
When a bulging aneurysm has a risk of bursting, aortic root surgery is performed.

For patients whose aortic valves are not functional, aortic root replacement involves replacing the valve as well as the root. Artificial or natural tissue components, or a combination of the two, may be used. A synthetic graft containing a valve is long-lasting but carries an increased risk of causing a blood clot, making it necessary to take anticoagulant drugs after the procedure. Alternatively, an aortic root and valve can be transplanted from a human tissue donor, or a valve from an animal may be fitted inside an artificial aortic root. Using biological valves means that anticoagulant medication is not required, but they are not as durable as mechanical versions.

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    • A diagram of the aorta, including the aortic root.
      By: bilderzwerg
      A diagram of the aorta, including the aortic root.
    • When a bulging aneurysm has a risk of bursting, aortic root surgery is performed.
      By: joshya
      When a bulging aneurysm has a risk of bursting, aortic root surgery is performed.
    • Undergoing an aortic root replacement may require a week-long hospital stay.
      By: Trish23
      Undergoing an aortic root replacement may require a week-long hospital stay.
    • A patient may spend several days in the intensive care unit following an aortic root replacement or other open heart surgery.
      By: Arkady Chubykin
      A patient may spend several days in the intensive care unit following an aortic root replacement or other open heart surgery.
    • During open-heart surgery, the chest is opened and a machine acts as the heart and lungs.
      By: Valeriy Velikov
      During open-heart surgery, the chest is opened and a machine acts as the heart and lungs.
    • Aortic root replacement surgery is used to treat swelling at the root of the aorta.
      By: peterjunaidy
      Aortic root replacement surgery is used to treat swelling at the root of the aorta.
    • Recovery from an aortic root replacement may take up to six weeks.
      By: Monkey Business
      Recovery from an aortic root replacement may take up to six weeks.