Aortic Root Repair and Replacement

The aortic root connects the aorta—the main artery that runs from the heart to the rest of the body. It surrounds the aortic valve. Aortic root surgery is a complex procedure used to prevent or treat an aortic aneurysm - a bulging, weakened area in the wall of the aorta that may rupture. A weak aortic root can also disrupt the aortic valve, causing it not to function properly.

Cardiac surgeons at the Brigham and Women’s Hospital (BWH) Heart & Vascular Center have extensive experience performing aortic root surgery, using complex repair and replacement procedures. Their advanced training and collaboration with a multidisciplinary team of specialists through the Structural Heart Disease Program enables our surgeons to handle the most complicated cases, with a range of treatment options that improve the lives of cardiac patients throughout the world. These include procedures that allow patients to avoid the use of long-term anticoagulants and minimally invasive treatment options that offer patients a faster recovery with less pain.

With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.

Aortic Root Repair and Replacement Topics

Aortic Root Repair and Replacement Procedures

Our surgeons perform several types of aortic root surgery, including:

  • Aortic root replacement removes a section of the aorta and the aortic valve. The section of the aorta is replaced with an artificial tube (graft), and the aortic valve is replaced with a mechanical or biological valve.
  • Valve-sparing aortic root replacement repairs aortic root aneurysms without replacing the patient’s own aortic valve. Preserving your own valve prevents long-term use of anticoagulants and may lower the risks of stroke and infection associated with valve replacement.
  • Composite aortic root replacement surgically repairs the aortic root and replaces the aortic valve with a prosthetic or synthetic valve made of artificial materials. This new valve is sewn into the base of a synthetic graft and used to repair diseased aortic valves occurring in conjunction with aneurysms of the aortic root.
  • Homograft valve/root replacement - In cases of complex valve and root disease, such as endocarditis or multiple previous root surgeries, the use of a tissue graft from a donated human heart may be indicated.

Learn about aortic valve repair and replacement surgery.

Learn about heart valve disease.

Why Have Aortic Root Repair or Replacement Surgery?

Aortic root repair or replacement surgery may be necessary:

  • If you have Marfan syndrome
  • If you have complications from high blood pressure such as an aneurysm or tear of the aortic wall
  • To reduce the risk of stroke
  • To reduce the risk of or because of endocarditis (infection of the heart)
  • To treat aortic aneurysm
What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Prior to surgery, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.

The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in aortic root disease. The Heart & Vascular Center is home to one of the most advanced hybrid operating rooms in the country. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.

Multidisciplinary Care

In addition to our cardiac surgeons, patients also benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.


Learn more about heart disease in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic at the Shapiro Cardiovascular Center.

Download Cardiac Surgery: A Guide for Patients in English or in Spanish.

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