When is aortic root replacement required?

Written in association with: Mr George Asimakopoulos
Published: | Updated: 09/01/2025
Edited by: Conor Lynch

Aortic root replacement is a highly specialized surgical procedure designed to address severe conditions affecting the aortic root, the portion of the aorta that connects to the heart and houses the aortic valve and coronary artery origins. This critical area plays a central role in maintaining proper blood flow from the heart to the rest of the body. Conditions that may necessitate this surgery include aortic root aneurysms, connective tissue disorders like Marfan syndrome, aortic valve dysfunction, and dissections involving the root.

The aortic root is vulnerable to conditions that can lead to life-threatening complications such as rupture or severe valve dysfunction. When the aortic root becomes dilated, weakened, or damaged, it increases the risk of catastrophic events, making surgical intervention essential. Aortic root replacement is a procedure performed to replace the diseased portion of the aortic root with a synthetic graft, ensuring structural integrity and restoring normal blood flow. 

 

In many cases, the surgery also involves addressing the aortic valve. Depending on the specific condition, the surgeon may opt for a valve-sparing technique, preserving the patient’s natural valve, or replacing it with a mechanical or biological prosthetic. The coronary arteries are carefully reattached to the new graft, ensuring the heart's blood supply is maintained.

 

This complex procedure typically requires open-heart surgery and the use of a heart-lung bypass machine. Recovery involves a hospital stay of several days, including time in intensive care for close monitoring.

 

Full recovery can take several weeks to months, during which patients gradually regain strength and resume normal activities under medical supervision. Advances in surgical techniques and post-operative care have led to excellent outcomes for most patients, significantly reducing the risks associated with aortic root disease.

 

Aortic root replacement is a life-saving procedure that not only prevents potentially fatal complications but also enhances the quality of life for patients with severe aortic conditions. Early diagnosis and expert care are vital, as they allow for timely intervention and improved long-term outcomes. This surgery underscores the importance of cardiovascular health and the transformative potential of modern cardiac surgery.

By Mr George Asimakopoulos
Cardiothoracic surgery

Mr George Asimakopoulos is a leading consultant cardiac surgeon based in London. His specialist interests include aortic root surgery, aortic valve replacement, surgery for endocarditis, Coronary Artery Bypass Grafting (CABG) and surgery for atrial fibrillation. He subspecialises in complex problems of the aortic valve, aortic root, ascending aorta and arch. He also has extensive experience in treating endocarditis and operating on patients who have had previous cardiac surgery.

In 1992, Mr Asimakopoulos qualified in medicine at The University of Hamburg, Germany. From 1999 to 2006, he trained on the West London rotation in cardiothoracic surgery. He went on to spend a year as a fellow in heart and lung transplantation at The Harefield Hospital.

Mr Asimakopoulos spent seven years working as a consultant cardiac surgeon at The University Hospitals Bristol NHS Foundation Trust. During his time at Bristol, Mr Asimakopoulos was one of the busiest cardiac surgeons in the UK. He performs more than 230 cardiac surgery operations every year. He also joined The Royal Brompton Hospital and Harefield Hospital in February 2014 as an aortic surgeon and continues to see patients at this highly regarded centre.

Mr Asimakopoulos is also an educational supervisor for trainee doctors in adult cardiac surgery. He regularly supervises medical students and sits on selection and interview panels for the national selection of surgical trainees.

He's published over 80 peer-reviewed scientific articles. Currently, he is taking part in ongoing research on the performance of sutureless aortic valves, outcomes of surgery for aortic dissection and training in cardiac surgery.

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