**10.2 Aortic remodeling technique**

Yacoub developed his technique of creating three longitudinal neo-sinuses [56]. These are sutured to the aorta and then coronary buttons are re-implanted. This method does not protect against annular dilatation [9]. In this technique the

#### **Figure 6.**

*The aortic remodeling technique is described. As shown, the aortic commissures are sewn to the graft, which is fashioned to form neo sinuses. Then the created tongues are sewn to the rim of the aortic wall. Coronary buttons re-implantation follows, then distal anastomosis between the graft and the ascending aorta is performed [9].*

**47**

provided the original work is properly cited.

, Salil V. Deo2

\*Address all correspondence to: yakov.elgudin@uhhospitals.org

*Aortic Root Reconstruction*

**11. Summary**

ing structures.

**Disclaimer**

Government.

**Author details**

Salah E. Altarabsheh1

Cleveland, Ohio, USA

*DOI: http://dx.doi.org/10.5772/intechopen.86034*

completed the procedure (**Figure 6**).

synthetic graft is fashioned into three longitudinal neo sinuses, then after securing the valve commissures to the neo graft, the margins of the neo sinuses are anastomosed to the rim of the aortic wall. Coronary button re-implantation to the neo sinuses follows, and distal anastomosis of the neo graft to the ascending aorta

Aortic root operations reflect complex anatomic relations and physiologic interactions between the left ventricle and components of the aortic root—ventriculoarterial junction (aortic annulus), sinuses of Valsalva, leaflets of the aortic valve, and sino-tubular junction. Whether a surgeon contemplates classic aortic root replacement with mechanical or tissue valve conduits or any of the valve sparing root reconstructions, close familiarity with the structure and function of the aortic root is necessary. Dreaded complications of such complex procedures (bleeding, most importantly) can be avoided by meticulous surgical technique in combination with intimate knowledge of the anatomical details of the aortic root and surround-

The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veteran Affairs or the United States

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

1 Department of Cardiac Surgery, Queen Alia Heart Institute, Amman, Jordan

2 Division of Cardiothoracic Surgery, Louis Stokes Cleveland VA Medical Center,

and Yakov E. Elgudin<sup>2</sup>

\*

#### *Aortic Root Reconstruction DOI: http://dx.doi.org/10.5772/intechopen.86034*

synthetic graft is fashioned into three longitudinal neo sinuses, then after securing the valve commissures to the neo graft, the margins of the neo sinuses are anastomosed to the rim of the aortic wall. Coronary button re-implantation to the neo sinuses follows, and distal anastomosis of the neo graft to the ascending aorta completed the procedure (**Figure 6**).
