Table (3)
The duration of aortic cross clamp is slightly longer by approximately 10 min compared to routine DVR; it didn’t make a significant difference in over-all management of patient. There is no incidence of intra-operative or post-operative bleeding, no excessive requirement of blood products. There was mild o moderate paravalvular leak in 1% and heart block in 1% in DVR without ARE.
Table (4)
With root enlargement one- two size bigger was replaced in 50 patients and PPM was eliminated in all patients. Nick′s was performed in (45) cases and Manouguian in (5) cases. Type of patches were used autologous pericardium in (35) cases, Dacron in (12) cases, and Bovine in (3) cases. There were no operative or in hospital mortality.