Technique for repair of recurrent aortic valve dehiscence

Re-operation for aortic paravalvular leak or multiple dehiscences due to Behcet's disease or unknown causes remains a challenge. We describe a modified transmural sub-coronary suturing technique to address this issue. Between August 2022 and May 2024, the modified transmural sub-coronary suturing technique was applied in five cases of severe aortic paravalvular leak. The median follow-up period was 14 months (ranging from 8 to 19 months) with promising outcomes: no mortality, no significant paravalvular leak, no atrioventricular block, and no need of re-operation. Our transmural sub-coronary suturing technique with external Dacron strip reinforcement demonstrates good short-term outcomes. Further long-term follow-up is needed to evaluate the long-term effectiveness of this technique.