Personalized External Aortic Root Support (PEARS) for Aortic Root Aneurysm

• Published in: Operative techniques in thoracic and cardiovascular surgery 2021, Vol.26 (2), p.290-305
• Main Authors: Kenny, Louise A., Austin, Conal, Golesworthy, Tal, Venugopal, Prem, Alphonso, Nelson
• Format: Article
• Language: English
• Subjects: connective tissue disease; PEARS; Personalized External Aortic Root Support (PEARS) for aortic root aneurysm; thoracic aortic aneurysm
• ISSN: 1522-2942; 1532-8627
• DOI: 10.1053/j.optechstcvs.2021.03.001

•A comprehensive overview of a novel management option for a patient with thoracic aortic aneurysm and a connective tissue aortopathy: Personalized External Aortic Root Support (PEARS).•Includes a description of the key principles of patient selection, surgical steps and postoperative care.•Detailed figures describing the implantation of a PEARS device with complementary video clips. The Personalized External Aortic Root Support (PEARS) procedure offers a novel alternative to traditional surgical options for aortic root aneurysms in patients with connective tissue disorders and neo-aortic root dilatation following the arterial switch or Ross procedures. It has a lower biological insult than conventional surgical management with shorter operating times and avoidance of cardiopulmonary bypass and cardioplegic arrest in most cases. The patient's own valve, root architecture, and blood to vessel wall interface are maintained. Avoidance of mechanical valve replacement negates the requirement for anticoagulation which is especially beneficial in young patients. This article aims to describe the key principles and operative steps for implanting the PEARS device. We describe the technical steps applicable to all PEARS implants and have included our tips and tricks at each stage. We consider PEARS to be a valid alternative therapeutic option for surgical teams managing patients with aortopathies.