All about aortic root replacement surgery

Aortic root replacement is a complex surgical procedure performed to treat conditions affecting the aortic root—the portion of the aorta attached to the heart. This section of the aorta houses the aortic valve and plays a vital role in blood flow from the heart to the rest of the body. When the aortic root becomes damaged or diseased, timely intervention is essential to prevent life-threatening complications like aortic rupture or heart failure.

Indications for aortic root replacement

The procedure is typically indicated for patients with conditions such as aortic aneurysms, Marfan syndrome, Loeys-Dietz syndrome, or other connective tissue disorders that weaken the aortic wall. It is also performed for patients with severe aortic valve disease or infection, such as endocarditis. Symptoms prompting evaluation for this surgery include chest pain, shortness of breath, and signs of heart failure, although in some cases, the condition is detected through routine imaging before symptoms arise.

The procedure

Aortic root replacement involves removing the diseased section of the aortic root and replacing it with a synthetic graft. In most cases, the aortic valve is also replaced or repaired during the surgery. Two common techniques are the Bentall procedure, which involves replacing both the aortic root and valve with a composite graft, and valve-sparing techniques, where the patient’s native valve is preserved if it remains functional.

The surgery is performed under general anaesthesia and often requires cardiopulmonary bypass, where a heart-lung machine temporarily takes over the function of the heart and lungs. The procedure typically lasts several hours and is followed by a recovery period in the intensive care unit.

Recovery and long-term outlook

Recovery from aortic root replacement includes a hospital stay of 5–10 days and several weeks of rehabilitation. Patients are advised to follow a heart-healthy lifestyle and attend regular follow-up appointments to monitor the function of the graft and aortic valve.

With advances in surgical techniques and postoperative care, the prognosis for patients undergoing aortic root replacement is excellent, offering them a renewed lease on life and improved long-term cardiovascular health.