Florida Sleeve for type A dissection

Abstract

In properly selected patients, an aortic root repair with valve salvage is a viable alternative to root replacement. Acute type A aortic dissections are often emergency operations with a high complexity. These cases are particularly difficult when the aortic root is enlarged, but the aortic valve leaflets and morphology are normal. In the setting of an acute ascending aortic dissection and enlarged aortic root, preservation of the valve via the use of the Florida Sleeve root repair technique is an alternative to root replacement. We present a case of our standard Florida Sleeve root repair in a patient with an ascending aortic aneurysm of 6.0 cm and an aortic root of 5.3 cm with moderate aortic insufficiency. The patient is a healthy 57-year-old male that had normal trileaflet anatomy but central aortic insufficiency appearing to be related to his root dilation on pre-operative echocardiogram. The Florida Sleeve technique for root remodeling with preservation of the aortic valve and sinuses is a technique for saving the aortic valve while narrowing the annulus and sinotubular junction. Familiarity with root replacement and valve preserving techniques during non-emergency setting is crucial in order to complete the procedure in an efficient manor during an aortic dissection operation.