Aortic root surgery

Updated: 2023-01-18

Overview

Aortic root surgery is a procedure to treat an enlarged section of the aorta, also known as an aortic aneurysm. The aorta is the large blood vessel that carries blood from the heart to the body. The aortic root is where the aorta and the heart connect.

Aortic aneurysms near the aortic root may be due to an inherited condition called Marfan syndrome. Other causes include heart problems present at birth, such as a bicuspid aortic valve.

Why it's done

Aortic root surgery is done to prevent:

• A rupture of the aorta.
• A tear between the layers of the aorta's wall, called an aortic dissection.
• Stretching of the aortic valve.

The risk of these events depends on the size of the aortic root and cause of enlargement. Aortic root surgery is recommended for those at high risk.

How you prepare

Before aortic root surgery, talk to your health care provider about the best treatment or surgery for your condition. Also discuss the benefits and risks of the surgery.

What you can expect

Ascending aortic root aneurysm procedure

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, called a 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. This procedure also is called composite aortic root replacement. A surgeon removes part of the aorta and the aortic valve. Then, the surgeon replaces the section of the aorta with an artificial tube, called a graft. The aortic valve is replaced with a mechanical or biological valve. Anyone who has a mechanical valve needs to take blood-thinning medicine, also called blood thinners, for life to prevent blood clots. Blood thinners also are called anticoagulants.
• Valve-sparing aortic root repair. A surgeon replaces the enlarged section of the aorta with a graft. The aortic valve stays in place. In one technique, the surgeon sews the valve inside the graft.

If you have another heart condition, your surgeon may be able to treat it at the same time as aortic root surgery.