Managing aortic and pulmonary root enlargement in donor organs

 

 

 

Managing aortic and pulmonary root enlargement in donor organs requires a meticulous, proactive strategy to ensure structural stability before implantation into an emergency recipient. Utilizing a double Personalized External Aortic Root Support (PEARS) approach with polytetrafluoroethylene (PTFE) mesh provides a tailored, non-reconstructive solution that stabilizes both the ascending aorta and the pulmonary trunk simultaneously. By leveraging custom 3D-printed models derived from donor CT angiograms, the PTFE micro-porous sleeves are precisely fabricated to match the specific geometry of the dilated roots. This double-sleeve configuration acts as an external scaffolding that prevents further aneurysmal progression and minimizes the risk of dissection under acute post-transplant hemodynamic stress, all while preserving the native endothelium and valvular architecture. In emergency scenarios, this technique avoids the prolonged ischemic times associated with complex root replacements, offering a rapid, biomechanically sound optimization of borderline donor vessels to safely expand the available pool for critically ill patients.