**Part 7**

**New Technology** 

216 Aortic Valve Surgery

Borroomee, L.; Batisse, A.; Lecompte, Y. et al. (1988). Anatomic repair of anomalies of

Chiavarelli, M.; Boucek, M.; Bailey, L. (1992). Arterial correction of double outlet left

Silva, P.; Baumgratz, F.; Fonseca, L. (2000). Pulmonary root translocation in transposition of great arteries repair. *Ann Thorac Surg*, Vol.69, (February 2000), pp643-5. Nikaidoh, H. (1984). Aortic translocation and biventricular outflow tract reconstruction. A

Hu, S.; Li, J.; Wang, X. et al. (2007). Pulmonary and aortic root translocation in the

Jatene, A.; Fontes, V.; Paulista, P. et al (1976). Anatomic correction of transposition of the great vessels. *J Thorac Cardiovasc Surg,* Vol.72, (March 1976), pp. 364-370. Bautista-Hernandez, V.; Marx, G. R.; Bacha, E. A. et al. (2007). Aortic Root Translocation

Furlanetto, G.; Henriques, S.; Furlanetto, B. (2010). New technique: aortic and pulmonary

Voges, I.; Fischer, G.; Scheewe, J. et al. (2008). Restrictive enlargement of the pulmonary

Outflow Obstruction. JACC, Vol. 49, (January 2007), pp. 485-90.

*Surg,* Vol.95, (January 1988), pp. 96-102.

1992), pp. 1098 –100.

2007), pp. 1090-2.

(September 1984), pp. 365-72.

(January/March 2010), pp. 99-102.

ventriculoarterial connection associated with ventricular septal defect. II. Clinical results in 50 patients with pulmonary outflow tract obstruction. *J Thorac Cardiovasc*

ventricle by pulmonary artery translocation. *Ann Thorac Surg*, Vol.53, (January

new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. *J Thorac Cardiovasc Surg,* Vol.88,

management of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction. *J Thorac Cardiovasc Surg*, Vol.133, (April

Plus Arterial Switch for Transposition of the Great Arteries With Left Ventricular

translocation with preservation of pulmonary valve. *Rev Bras Cir Cardiovasc*, Vol.25,

annulus at surgical repair of tetralogy of Fallot: 10-year experience with a uniform surgical strategy. *Eur J Cardiothorac Surg*, Vol.34, (November 2008), pp. 1041-5.

**13** 

**An Expansible Aortic Ring for a Standardized and Physiological** 

**Approach of Aortic Valve Repair** 

*2Vascular Surgery Department, Foch Hospital, Suresnes 3Inserm U698, Bioengineering for Cardiovascular Imaging and* 

*5Cardiac Surgery Department, La Tronche Hospital,* 

 *Therapy Team CHU Xavier Bichat, Paris 4IUT Saint Denis, Paris 13 University* 

*6Cardiac Surgery Nancy Hospital, Nancy,* 

*7CoroNéo Inc, Montreal* 

*1,2,3,4,5,6France 7Canada* 

Emmanuel Lansac1, Isabelle Di Centa2, Rémi Escande3, Maguette Ba3,4, Nizar Kellil3, Eric Arnaud Crozat5, Eric Portocarrero6, Aicha Abed3,4, Anthony Paolitto7, Mathieu Debauchez1 and Anne Meddahi- Pellé3,4 *1Institut Mutualiste Montsouris, Cardiovascular Surgery Department, Paris* 

Dystrophy of the ascending aorta is the main etiology of thoracic aortic aneurysms and/or pure aortic insufficiency (tricuspid or bicuspid valves) operated in western countries (Iung et al., 2003; Roberts et al., 2006). It includes two phenotypes depending on whether the sinuses of Valsalva and/or supracoronary aorta are dilated: 1) isolated AI and/or supracoronary aneurysm (sinuses of Valsalva<40 mm); 2) aortic root aneurysms (sinuses of Valsalva>45 mm) (Lansac et al., 2008). Until recently, prosthetic valve replacement was the only surgical option for AI, performing either isolated valve replacement, composite valve and graft replacement or supracoronary graft and/or valve replacement. However, none of the current valve substitutes are ideal options, since mechanical valves require life-long anticoagulation and bioprosthetic valves present the risk of reoperation (Houel et al., 2002). Inspired by mitral experience, reconstructive methods have been developed to treat AI, based on sparing or repairing the native aortic valve, while replacing or stabilizing the other components of the aortic root. The two original valve sparing procedures - remodeling of the aortic root and reimplantation of the aortic valve - focused on root reconstruction to reduce the dilated root diameters in order to restore proper valve function. "Remodeling" technique provides the most physiological reconstruction of the root, but it does not address the dilated annular base (Yacoub et al., 1983). Alternatively, the Reimplantation, as an inclusion technique, provides a subvalvular annuloplasty to the detriment of valve dynamics (David & Feindel, 1992). Numerous technical variations aimed to associate

**1. Introduction** 
