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Ann Thorac Surg 2002;73:1117-1121
© 2002 The Society of Thoracic Surgeons

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Original article: cardiovascular

Aortic root remodeling operation: how do we tailor a tube graft?

^a Department of Thoracic and Cardiovascular Surgery and Second Department of Anatomy, Sapporo Medical University School of Medicine, Sapporo, Japan

Accepted for publication December 18, 2001.

* Address reprint requests to Dr Morishita, Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8556, Japan
e-mail: kmori{at}sapmed.ac.jp

Background. In aortic root remodeling operation, it is difficult to perform graft sizing and tailor a graft appropriately. Thus the aim of this study was to create guidelines for sizing and tailoring that would help to standardize the operation.

Methods. We studied the anatomy of the aortic root and assessed the reliability of three equations reported to assist in graft sizing with aortic root casts obtained from 127 cadavers.

Results. Yacoub’s equation and ours accurately predicted the diameter at the sinotubular junction. Three cusps of the aortic valve were not equal in size. Sinus height of the aortic root was unpredictable.

Conclusions. Based on these results, we recommend that aortic root remodeling operation should be performed as follows: (1) graft sizing should be performed using Yacoub’s way or our way; (2) the tube graft should be cut into three parts in proportion to the size of each cusp; and (3) the position of the commissures in the tube graft should be secured with sutures first, and the depth of the sinuses should be determined later.

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