Andras C. Kollar, MD, PhD, Scott D. Lick, MD, Vincent R. Conti, MD

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Valve-Sparing Aortic Root Reconstruction Using In Situ Three-Dimensional Measurements Andras C. Kollar, MD, PhD, Scott D. Lick, MD, Vincent R. Conti, MD The Annals of Thoracic Surgery Volume 87, Issue 6, Pages 1795-1800 (June 2009) DOI: 10.1016/j.athoracsur.2009.03.043 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Three-dimensional downsizing with the native aortic root intact. Sets of two vertically placed externally pledgeted subcommissural annuloplasty sutures and three mid-sinus level temporary plication sutures are placed 120 degrees apart at the sinotubular junction (see details in text). The Annals of Thoracic Surgery 2009 87, 1795-1800DOI: (10.1016/j.athoracsur.2009.03.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Integrated aortic root reconstruction. The entire aortic annulus is sandwiched between graft material and pledgets with the suture line following the three-dimensional coronet. (Reprinted with permission from Kollar [14].) The Annals of Thoracic Surgery 2009 87, 1795-1800DOI: (10.1016/j.athoracsur.2009.03.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Follow-up (2 months) transthoracic echocardiography study of the neoaortic root in patient number 9 (parasternal long-axis view in systole [A] and in diastole [B]). Note the elongated leaflets (arrows) in the open position (A) and showing good coaptation in the midline during diastole (B). The dashed line delineates the overall geometry of the reconstructed root (sinotubular junction greater than basal ring size). The Annals of Thoracic Surgery 2009 87, 1795-1800DOI: (10.1016/j.athoracsur.2009.03.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions