A modified valve-sparing aortic root replacement technique for acute type A aortic dissection: the patch neointima technique.

We describe a modified valve-sparing aortic root replacement technique for acute type A aortic dissection. After the normal root geometry was restored by removing blood and clots in the proximal false lumen and the valve insufficiency was corrected by simple resuspension of the aortic commissures, three teardrop-shaped patches were sutured inside the sinuses as neointima and then in situ coronary buttons were connected to the small holes created in the corresponding patches. Our initial application showed that this modified valve-sparing aortic root replacement technique is an easy and effective way to restore the geometry of the aortic root and avoid bleeding during surgery for acute type A dissection.