Remodeling of the aortic valve anulus.

Isolated aortic valve regurgitation that results from disease that primarily affects the aortic wall can be repaired by remodeling of the aortic anulus to restore its normal geometry. This involves excision of the aortic wall to within 2 to 3 mm of the leaflet attachments, detachment of the coronary ostia, reshaping of the anulus with the aid of a Dacron graft, and then reimplantation of the coronary arteries. Increases in the surface area of the leaflet that are caused by root dilatation are often present and can be accommodated in the repair procedure. In this study we describe our experience with 10 patients with annuloaortic ectasia who underwent the remodeling procedure at the National Heart Hospital and the Royal Brompton Hospital from 1982 to 1990.