A new aortic Dacron conduit for surgical treatment of aortic root pathology

Abstract

Background: This article describes a new aortic Dacron conduit that has been designed for use in all types of surgery of the aortic root. Its use is aimed at facilitating the surgical procedure and obtaining a natural anatomical configuration of the aortic root.

Methods: The modified Dacron conduit is obtained by adding a smaller piece of Dacron tube that is resilient in the horizontal plane to one end of a standard Dacron conduit. Upon implantation, this small piece of Dacron conduit will stretch in the horizontal plane creating pseudosinuses and a new sinotubular junction. This modified conduit has been used in 4 cases for a Bentall operation in association with a mechanical or a biological valve, in 4 cases in a Yacoub type of valve sparing procedure and in 1 case in a David type I of valve sparing procedure. All patients had aortic root aneurysm with severe aortic regurgitation. There were 6 males and 3 females with a mean age of 61 +/- 16 years. In most cases a 28 mm Dacron conduit was used.

Results: All surgery was carried out without mortality or morbidity. The creation of pseudosinuses was confirmed intraoperatively by visual inspection. Transesophageal echocardiography in patients who had undergone the Bentall operation showed a normally functioning valve prosthesis with a suitably shaped aortic root. In patients who had undergone the valve sparing procedures it showed a competent aortic valve, the creation of pseudosinuses of normal shape and depth, and the presence of a well defined sinotubular junction. Angiography confirmed that the prosthetic aortic root perfectly resembled the normal root anatomy.

Conclusions: This modified new aortic root conduit appears to perfectly reproduce a normal root anatomy without the need of modifying the original techniques.