Root Reimplantation With Leaflet Repair.

Reimplantation of the aortic valve is a procedure well recognized for its safety, excellent success in preserving the leaflets without a composite valve graft, and long-term durability. Unanswered questions are whether the procedure should be used for bicuspid valves and, if so, which ones, and also the role of leaflet repair. In our experience with just under 2000 aortic valve repairs, we found that use of a root procedure, particularly root reimplantation, resulted in excellent long-term durability. Just as with mitral valve repairs that include an annular ring, it appears that for aortic valve repairs, bracing the root is important. We have found that leaflet repair during a reimplantation procedure is not detrimental to long-term durability.