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Concomitant replacement of the ascending aorta with the aortic valve in patients who have left ventricular dysfunction might carry high operative risks. Performing the conservative reduction aortoplasty was shown to have less complications in such patients. When combined with other concomitant cardiac procedures, the newly described “spiral” aortoplasty technique in this series allows for a mulitplanar wall tension reduction in moderately dilated ascending aorta.

Spiral aortoplasty for dilated ascending aorta: a new technique for high-risk patients with combined procedures