Reoperative Aortic Root Surgery in Adults with Prior Conotruncal Repair

Conotruncal anomalies comprise a heterogeneous group of congenital heart defects arising from abnormal embryologic development of the cardiac outflow tract and the great arteries. Aortic root dilatation represents a frequent yet comparatively underexplored finding in this population, and clear guidelines regarding surveillance and surgical treatment remain limited. This article reviews mechanisms of aortic root dilatation, diagnostic evaluation, and surgical indications and principles for aortic root surgery in adults with conotruncal anomalies, including lesion-specific considerations for Tetralogy of Fallot, d-transposition of the great arteries, truncus arteriosus, and double outlet right ventricle.