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However, both mechanical and biological aortic valve replacement have major disadvantages, especially in young patients. Aortic valve-preserving surgery has attracted a great deal of attention because it has a significant survival benefit over replacement. Nonetheless, aortic valve-preserving surgery has not been widely adopted due to the complexity of the technique and assessment (i.e., long learning curve). With recent technical and theoretical advances, aortic valve-preserving surgery has increasingly been performed with better outcomes, and therefore earlier surgical intervention in cases of aortic regurgitation has been considered. Recent advances in aortic valve-preserving surgery include repair-oriented classification of the etiology of aortic regurgitation, objective assessment of the cusp configuration (i.e., effective height and geometric height), use of aortic annuloplasty, introduction of two reproducible valve-sparing root replacement procedures (i.e., aortic valve reimplantation and aortic root remodeling techniques), standardization of aortic valve-preserving surgery, and assessment of cusp configuration with aortoscopy. A number of prospective multicenter studies are currently underway and will clarify the role of aortic valve-preserving surgery in the treatment of aortic regurgitation in the near future.<\/jats:p>","DOI":"10.1177\/0218492320975937","type":"journal-article","created":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T23:42:01Z","timestamp":1606088521000},"page":"443-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Current trends in aortic valve-preserving surgery"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6903-6501","authenticated-orcid":false,"given":"Takashi","family":"Kunihara","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,22]]},"reference":[{"key":"bibr1-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2007.10.008"},{"key":"bibr2-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.045"},{"key":"bibr3-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"bibr4-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.07.043"},{"key":"bibr5-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.02.077"},{"key":"bibr6-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-017-0874-x"},{"key":"bibr7-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70360-X"},{"key":"bibr8-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.015"},{"key":"bibr9-0218492320975937","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"bibr10-0218492320975937","unstructured":"JCS\/JSCS\/JATS\/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection. 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