Aortic root replacement with the BioValsalva prosthesis

Aortic root replacement with a composite valve graft, according to the Bentall technique and its following modifications [1, 3, 13], represents the treatment of choice for pathologies affecting the aortic root and the aortic valve. The increasing number of elderly patients with complex diseases of the aortic valve and ascending aorta, and the disadvantages of anticoagulation and thromboembolism associated with mechanical valves are stimulating the search for an ideal substitute [9, 16, 17]. Homografts, composite conduits with a biological stented or stentless valve prosthesis intraoperatively assembled and stentless xenografts are currently available, each with its advantages and disadvantages [9, 11, 12, 15, 18]. A new prepacked biological conduit, the BioValsalva porcine aortic valved conduit, has been developed offering the surgeon a new treatment option for elderly patients with combined disease of the aortic valve and root or for patients in whom anticoagulation should be avoided or is contraindicated.