The aorta is the main artery of the body, originating in the heart and distributing oxygenated blood throughout the body. The most proximal portion is called the aortic root and in those few centimeters are included the exit of the left ventricle, the aortic valve and the origins of the coronary arteries.
Why does it have to be treated by surgery?
The most important clinical repercussion of the aortic root is its dilatation.
Dilatation of the aortic root can cause a separation of the aortic valve attachment zones, generating a lack of contact of the aortic leaflets and a defective closure of the valve with a corresponding more or less severe leakage of blood into the left ventricle, i.e., aortic valve insufficiency.
It is also possible that the aortic valve is degenerated and although its size is normal, it is associated with a dilatation of the first portion of the aorta where the origins of the coronary arteries are located.
The surgical indication is marked by the degree of valvular involvement or by the degree of dilatation of the aortic root.
Poor valve function has repercussions on the function of the left ventricle and consequently on the quality and prognosis of life.
Excessive dilatation of the aortic root carries an associated risk of rupture of some of the layers of the aorta, known as aortic dissection, which requires urgent surgery.
Solving the valvular problem and the dilatation of the aortic root entails the need to reposition the origins of the coronary arteries. This can only be achieved with open surgery.
What are the benefits of this procedure for the patient?
If the degree of valvular involvement is important, the correction of this problem will lead to an improvement in the clinical condition and a better prognosis.
If the indication for surgery is due to the increased diameter of the root and valve function is practically normal, the patient will be asymptomatic before and after surgery, but the risk of aortic rupture or dissection will have disappeared.
Risks and contraindications.
The risk of elective surgery, i.e. surgery that is not performed as an emergency or due to an added complication, is no greater than that of elective surgery on the aortic valve. Very low surgical risk figures.
In aortic root surgery, in addition to the elimination of dilatation and reimplantation of the coronary arteries, aortic valve repair techniques can be performed while preserving the patient’s own valve, as well as all valve replacement techniques using mechanical and biological prostheses (of animal or human origin).
Aortic root surgery alone does not present any contraindication. However, as in most cardiac surgery, it is the patient himself who, due to his general condition and life expectancy and quality of life, may advise against surgical intervention.