Aortic valve sparing strategies have a valuable potential to treat the patient's valvular disease. In contrast to the mitral and tricuspid valve, aortic repair is more difficult with respect to specific valve features.
Authors give a historical overview of the evolution of surgical concepts to achieve the valve competency. Over the period of 70 years, manifold innovative approaches were tested in relation to contemporary level of knowledge in search of effective, standardized, safe and durable reconstructive procedures.
Current focus on three geometrical components of aortic valve competency is a logical heir to this long-lasting effort.