1. Novel Technique of Valve-Sparing Aortic Root Replacement in Two Children Younger Than 3 Years of Age 
James K. Kirklin, MD, Walter H. Johnson, MD, Barton B. Cook, MD, Mark A. Law, MD, William S. McMahon, MD, Robb L. Romp, MD, Edward V. Colvin, MD 
The Annals of Thoracic Surgery 
Volume 94, Issue 1, Pages (July 2012)
DOI: /j.athoracsur
Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
(A) Aortic root aneurysm with initial sites of aortic transaction and excision of sinuses with coronary ostia (dashed lines). (B) Complete excision of aortic wall, leaving 3- to 4-mm rim of aorta above leaflet hinge points. The number 1 refers to the noncoronary sinus of Valsalva; 2 refers to left sinus; and 3 refers to right sinus. Letter “a” refers to the width of the neosinus and “b” to the height of the neosinus. (C) Three-millimeter–wide rings are cut from woven graft of size equal to external annular diameter. Lower ring is secured at subannular level by placing 3 pledgeted mattress sutures of 3-0 polyester suture below level of aortic valve leaflets at nadir of each leaflet. The upper ring is positioned to secure commissural posts at level of sinotubular junction. (D) Pseudosinuses are created from 3 separated patches of bovine pericardium. The dimensions are indicated in C and D. (E) Completed sinus of Valsalva reconstruction. (F) Reimplantation of coronary buttons into bovine pericardial patches. (G) Second graft is used to complete ascending aortic replacement.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions