Aortic valve–sparing reimplantation for dilatation of the ascending aorta and aortic regurgitation late after repair of congenital heart disease

A, After mobilization of the aortic root, coronary buttons were excised and aortic sinuses up to a remnant of 2 to 3 mm were resected. B, A proximal anastomosis was performed with 12 to 15 threads of 3-0 coated polyester fiber used as horizontal mattress sutures placed through the annulus underneath the valve. C, The aortic cuff, including the commissures, was reimplanted into the Dacron prosthesis (28 or 30 mm) with three 4-0 polypropylene sutures using a running technique. The coronary buttons were also reimplanted into the prosthesis.