A Novel Selective Sinus Reinforcement Technique for Acute Type A Aortic Dissection Involving the Aortic Root.

BACKGROUND: Acute type A aortic dissection (ATAAD) commonly involves the aortic root. We developed a novel selective sinus reinforcement (SSR) technique. This study aimed to investigate the feasibility, effectiveness and safety of this technique. METHODS: Between January 2018 and January 2022, a total of 361 consecutive patients underwent surgery for ATAAD. Of these, 186 patients (51.5%) were treated using the SSR technique to repair the involved root. RESULTS: The extent of sinus repair was stratified as follows: single sinus in 62.9%, two sinuses in 30.1%, and all three sinuses in 7.0%. Postoperatively, 5 patients (2.7%) required re-exploration for bleeding unrelated to the root procedure. At a mean follow-up of 35.2 ± 8.5 months, the 3-year overall survival rate was 94.6%. One patient required valve reintervention at 2 years due to late prolapse with severe aortic insufficiency. CONCLUSIONS: For ATAAD involving the root, the SSR technique offers a simplified and potentially safer surgical alternative, demonstrating durable aortic valve competence and excellent root stability.