July 2020 Br J Cardiol 2020;27:87–92 doi:10.5837/bjc.2020.022
John Pepper, Tal J Golesworthy, Cemil Izgi, Johanna J M Takkenberg, Tom Treasure
Introduction Prophylactic replacement of the aortic root aims to resect the aortic aneurysm and so mitigate the risk of dissection or rupture. There are two established surgical techniques: total root replacement (TRR), which involves replacement of the aortic root and valve with a composite valve conduit, or valve-sparing root replacement (VSRR). TRR is now a straightforward operation with a low operative risk, but it involves replacement of the aortic valve, which is normal in many patients. This then commits the patient either to life-long anticoagulation with a mechanical valve, or structural valve degeneration if a tissue valve is used.