Reconstruction and Replacement of the Aortic Root in Destructive Endocarditis

Surgical treatment of endocarditis causing destruction of the aortic root is challenging, requiring surgical expertise and a repertoire of techniques. The major goals of surgery are to achieve drainage of abscess cavities, radical annular debridement and aortic valve replacement without abnormal mechanical stress on the suture line. This approach can help avoid some major complications that may occur postoperatively: recurrence or persistence of infection and prosthetic valve dehiscence. A number of procedures are available to manage a wide spectrum of pathology that may be encountered. We have outlined a number of surgical techniques that can be used for aortic root reconstruction in the setting of extensive destruction.