Strategies to Minimize Coronary Malperfusion in Bioprosthetic Aortic Root Replacement

Highlight

• Coronary malperfusion requiring coronary revascularization post-aortic root replacement occurred in only 1.3% of patients undergoing Freestyle stentless bioprosthetic root replacement.
• Technical improvements such as avoiding oversizing the root and extensive coronary button mobilization significantly reduced adverse coronary outcomes compared to earlier series.
• Coronary artery dissection related to type A aortic dissection and concomitant coronary interventions remain important considerations in this population.
• The Cabrol procedure was selectively used in 6% of patients with coronary calcification or stenosis to optimize coronary flow.