Aortic Root Aneurysms

In a homograft root replacement (above left), the aorta and aortic valve, as well as the attachment of the coronary arteries, are replaced with an aortic root from a human donor (above right).

At NewYork-Presbyterian Hospital/Columbia University Medical Center (NYPH/Columbia), we offer a broad spectrum of treatment options tailored to the individual needs of the patient. Patients are evaluated with Echocardiogram, CT Scan, and cardiac catheterization, when required. The data is examined and an intensive discussion with the patient and family regarding replacement options occurs.

When possible, the patient's aortic valve is preserved while all damaged aorta is removed. This procedure is known as a David procedure (aortic valve sparing root replacement) and is detailed below. The advantage of this procedure is that it allows for replacement of the aorta while eliminating the need for life-long anticoagulation.

When the aortic valve cannot be spared, there are several prosthetic options. For patients who wish to avoid anticoagulation, we offer a homograft root replacement. This procedure involves removal of the aorta and the aortic valve, as well is the attachment of the coronary arteries. The aortic root is then reconstructed with the aid of a donor human aorta. This procedure has the advantage of avoiding anticoagulation and providing a human valve with superior hemodynamic function. There is a fair amount of evidence that supports a longer freedom from reoperation than the animal tissue alternatives.

In younger patients or in those patients who wish to avoid reoperation, a mechanical valve conduit is offered. This device is a combination of a mechanical valve with an attached tube graft. The entire aortic root is removed and this conduit is used for reconstruction.

To learn more about these procedures, please click here.