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Redo valve replacement

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https://www.readbyqxmd.com/read/28096837/sutureless-aortic-valve-and-mitral-valve-repair-in-redo-cases-really-an-off-label-approach
#1
Júlia Čanádyová, Aleš Mokráček, Vojtěch Kurfirst
Sutureless aortic valve replacement (AVR) was developed as an alternative treatment option to conventional open-heart surgery and transcatheter aortic valve implantation for "gray zone" patients. The need for concurrent mitral valve surgery is generally viewed as a contraindication to sutureless AVR. The purpose of this brief paper is to report our experiences with sutureless valves in patients after previous cardiac procedures with degenerated aortic bioprostheses and concomitant mitral valve disease.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28070934/long-term-outcomes-after-mechanical-aortic-valve-replacement-with-aortic-root-enlargement-in-adolescents
#2
Zhiwei Xu, Qiuxia Shi, Ju Mei, Yan Tan
BACKGROUND: Deciding which prosthetic aortic valve to choose is difficult in adolescents who have not yet met their full growth potential. The aim of this study was to assess long-term outcomes following mechanical aortic valve replacement with aortic root enlargement in adolescents. METHODS: Between September 1997 and December 2006, 58 consecutive adolescents (49 male, 9 female, median age 15.5, range 13 to 17 years) underwent mechanical aortic valve replacement with aortic root enlargement...
January 10, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28067715/incidence-risk-factors-clinical-impact-and-management-of-bioprosthesis-structural-valve-degeneration
#3
Nancy Côté, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Structural valve deterioration is the major cause of bioprosthesis failure and is increasing over time. We present an overview of incidence, mechanisms, predictors, clinical impact, and management of bioprosthetic valve structural degeneration. RECENT FINDINGS: Early degeneration caused by calcification and destruction of connective tissue of the prosthesis is controlled by multiple mechanisms, from mechanical stress to infiltration of lipids and inflammatory cells, and activation of the immune system...
January 6, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28062549/redo-procedures-for-degenerated-stentless-aortic-xenografts-and-the-role-of-valve-in-valve-transcatheter-techniques%C3%A2
#4
Herko Grubitzsch, Sebastian Zobel, Torsten Christ, Sebastian Holinski, Karl Stangl, Sascha Treskatsch, Volkmar Falk, Michael Laule
OBJECTIVES: This study evaluates reinterventions for degenerated stentless aortic xenografts. METHODS: Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). RESULTS: Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)...
January 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28050429/redo-mitral-valve-replacement-for-prosthetic-valve-thrombosis-single-center-experience
#5
Jignesh Kothari, Kartik Patel, Bhavin Brahmbhatt, Kinnaresh Baria, Malkesh Talsaria, Sanjay Patel, Sandeep Tailor
INTRODUCTION: Prosthetic Valve Thrombosis (PVT) remains a significant cause of morbidity and mortality after valve replacement. Although surgical treatment is usually preferred as life-saving in cases of obstructive PVT, optimal treatment is yet to be decided. AIM: To evaluate risk factors and outcome of the patients undergoing redo mitral valve surgery for acute PVT. MATERIALS AND METHODS: Between January 2012 and February 2015, 65 patients underwent redo surgery for obstructive PVT of mitral valve in Department of Cardiothoracic Surgery, UN Mehta Institute of Cardiology & Research Centre...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28009947/root-replacement-for-graft-infection-using-an-all-biologic-xenopericardial-conduit
#6
Sabina P W Guenther, Angela Reichelt, Sven Peterss, Maximilian Luehr, Erik Bagaev, Christian Hagl, Maximilian A Pichlmaier, Nawid Khaladj
BACKGROUND: The management of graft infection following ascending aortic replacement (AAR) and/or aortic valve replacement (AVR) with destruction of the root remains a challenge. Besides technical issues, the choice of graft material is controversial. The study aim was to investigate the initial results of aortic root replacement (ARR) as redo-surgery for infection using the xenopericardial all-biologic conduit (BioIntegral) as an alternative to a homograft or prosthetic material. METHODS: Between February 2013 and January 2015, a total of 18 consecutive patients (16 males, two females; mean age 61 ± 14 years) were reoperated on for infection at a mean of 55 ± 61 months (range: 3 to 219 months) following previous AVR (n = 6), supracoronary aortic replacement (SAR, n = 2), AVR + SAR (n = 1), root replacement (n = 7), and root reconstruction (n = 2)...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28007882/redo-aortic-root-replacement-reutilizing-22-year-patent-modified-cabrol-grafts
#7
Akiko Tanaka, Shaikh Afaq, Scott Atay, Anthony Estrera
Long-term patency of modified Cabrol technique in composite aortic root replacement is not well documented. We report a unique case in which a patient presented for prosthetic valve dysfunction with patent Cabrol grafts 22 years after composite root replacement requiring redo aortic root. This case also demonstrates how modified Cabrol grafts can be reutilized in aortic root replacement without compromising adequate fluid dynamics.
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28007290/dacron-skirt-reconstruction-of-the-left-ventricular-outflow-tract-extending-the-capabilities-of-a-valved-conduit
#8
Jai Raman, David T M Lai, Nikola Dobrilovic, Salim Aziz
Aortic root reconstruction in the setting of redo aortic valve procedures or infective endocarditis may be technically challenging, particularly because of variable destruction or distortion of the left ventricular outflow tract. Homograft aortic root replacement is an excellent option for aortic root abscesses but is limited by homograft availability. We describe a simple technique of a bioprosthetic valved conduit constructed on the table using a Dacron (DuPont, Wilmington, DE) skirt below the valve. The use of the Dacron skirt facilitates easy reconstruction of the left ventricular outflow tract...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27989073/surgical-management-and-postoperative-outcomes-of-mechanical-valve-dysfunction-a-six-year-single-center-study
#9
Mingwen Li, Yingbin Xiao, Lin Chen
BACKGROUND: Although many mechanical heart valves are replaced worldwide each year, mechanical valve dysfunction (MVD) remains one of the most common complications following this surgery. In an attempt to improve the postoperative and surgical management of MVD, the study plan was to investigate a group of patients who had undergone redo mechanical valve replacement to treat MVD at the authors' institution. METHODS: A total of 52 consecutive patients diagnosed with MVD underwent redo mechanical valve replacement between January 2007 and December 2013...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27966257/twenty-five-year-outcomes-following-composite-graft-aortic-root-replacement
#10
Salvior C M Mok, Wei-Guo Ma, Ahmed Mansour, Paris Charilaou, Alan S Chou, Sven Peterss, Maryann Tranquilli, Bulat A Ziganshin, John A Elefteriades
BACKGROUND: Operative choices for aortic root disease include traditional root replacement with a composite valved graft as well as various valve-sparing and root repair procedures. OBJECTIVES: To report our experience with traditional composite graft aortic root replacement by a single surgeon over a 25-year period in 449 patients, focusing on long-term survival and freedom from late reoperation and adverse events. METHODS: The coronary button technique was used in all patients...
December 14, 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27964981/aortic-root-surgery-with-circulatory-arrest-predictors-of-prolonged-postoperative-hospital-stay
#11
Ourania Preventza, Joseph S Coselli, Andrea Garcia, Shahab Akvan, Sarang Kashyap, Katherine H Simpson, Matt D Price, Kim I de la Cruz, Konstantinos Spiliotopoulos, Lorraine D Cornwell, Faisal G Bakaeen, Shuab Omer, Denton A Cooley
OBJECTIVE: Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery. METHODS: During 2006-2014, 247 of 265 patients (93.2%) with disease extending into the aortic arch survived aortic root operations (206 elective, 41 urgent/emergent) in which hypothermic circulatory arrest with moderate hypothermia was used...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27939498/elective-primary-aortic-root-replacement-with-and-without-hemiarch-repair-in-patients-with-no-previous-cardiac-surgery
#12
Ourania Preventza, Joseph S Coselli, Matt D Price, Katherine H Simpson, Ouyang Yafei, Kim de la Cruz, Qianzi Zhang, Susan Green
OBJECTIVE: Excellent outcomes have been established for elective aortic root replacement (ARR). It is less clear whether extending the repair into the proximal aortic arch with hypothermic circulatory arrest increases risk. We examined the early outcomes of elective, primary ARR, with and without hemiarch replacement, in patients without previous cardiac surgery. METHODS: Over a 4-year period, 140 non-redo patients (median age, 54 years) underwent elective, primary ARR for root aneurysms; 119 patients (85%) had hemiarch replacement, and 21 (15%) had only ascending aortic replacement...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27928260/emergency-redo-mitral-valve-replacement-immediately-after-caesarean-section
#13
İbrahim Duvan, Ümit Pınar Sungur, Burak Emre Onuk, Mehmet Şanser Ateş, İbrahim Sami Karacan, Murat Kurtoğlu
Surgery for heart diseases during pregnancy, especially necessitating cardiopulmonary bypass, is believed to trigger maternal and fetal risks and should be performed only when medical therapy has been unsuccessful to alleviate the cardiac decompensation. A 33-year-old pregnant woman in her 33rd week of gestation was admitted to our hospital. She had rheumatic mitral valvular stenosis and had undergone mitral valve replacement (MVR) with a mechanical prosthesis 11 years earlier in another center. Echocardiography revealed a thrombotic mass obstructing the leaflets of the mechanical mitral valve...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27910125/bioprosthetic-tricuspid-valve-replacement-for-tricuspid-valve-endocarditis-secondary-to-infected-endocardial-pacemaker-leads
#14
Zhiwei Xu, Qiuxia Shi, Ju Mei, Yan Tan
BACKGROUND: The purpose of this study was to present outcomes of bioprosthetic tricuspid valve replacement (TVR) in patients with tricuspid valve infective endocarditis (TVIE). METHODS: From October 2001 to December 2015, 26 patients underwent a bioprosthetic TVR due to severe TVIE after endocardial pacemaker implantation. RESULTS: Staphylococcus species and Streptococcus species were the predominant microorganisms. Early 30-day hospital mortality was 0 (0%)...
January 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27909274/-three-mitral-valve-operations-in-a-patient-with-trousseau-syndrome-and-nonbacterial-thrombotic-endocarditis-caused-by-ovarian-cancer
#15
Masahito Saito, Naoki Asano, Kazunori Ota, Kazuho Niimi, Koyu Tanaka, Shigeyoshi Gon, Hiroshi Takano
A 52-year-old woman was admitted to our hospital for acute right hemi-paresis, left homonymous hemianopia, and fever. Magnetic resonance imaging of the brain showed multiple cerebral infarctions and transesophageal echocardiography (TEE) revealed a vegetation on the posterior leaflet of her mitral valve. Mitral valve repair was performed under a diagnosis of infective endocarditis (IE). Further multiple cerebral infarctions occurred on the 11th postoperative day, resulting in left hemiplegia and dysarthria...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27895692/impact-of-postoperative-duration-of-aspirin-use-on-longevity-of-bioprosthetic-pulmonary-valve-in-patients-who-underwent-congenital-heart-disease-repair
#16
Tae-Woong Hwang, Sung-Ook Kim, Sang-Yun Lee, Seong-Ho Kim, Eun-Young Choi, So-Ick Jang, Su-Jin Park, Hye-Won Kwon, Hyo-Bin Lim, Chang-Ha Lee, Eun-Seok Choi
PURPOSE: Generally, aspirin is used as a protective agent against thrombogenic phenomenon after pulmonary valve replacement (PVR) using a bioprosthetic valve. However, the appropriate duration of aspirin use is unclear. We analyzed the impact of postoperative duration of aspirin use on the longevity of bioprosthetic pulmonary valves in patients who underwent repair for congenital heart diseases. METHODS: We retrospectively reviewed the clinical data of 137 patients who underwent PVR using a bioprosthetic valve between January 2000 and December 2003...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#17
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27772598/redo-aortic-valve-implantation-after-full-root-replacement-using-a-sutureless-valve-prosthesis
#18
Julia Götte, Wolfgang Hemmer, Detlef Roser, Markus Liebrich, Nicolas Doll
We report the case of a 83-year-old man who had undergone a full root replacement with a stentless bioprosthesis 15 years earlier. He was now diagnosed with severe aortic valve regurgitation secondary to leaflet degeneration, moderate mitral regurgitation, and single-vessel coronary artery disease. To reduce cross-clamp time and technical difficulties a sutureless aortic prosthesis was used. His surgery and postoperative course were uneventful. This is the first report of the successful use of a sutureless aortic valve prosthesis in a patient after bioprosthetic full root replacement who required additional mitral repair and coronary artery bypass surgery...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27765308/transcatheter-aortic-valve-replacement-the-new-standard-in-patients-with-previous%C3%A2-coronary%C3%A2-bypass%C3%A2-grafting
#19
Jochen Reinöhl, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Manfred Zehender, Constantin von Zur Mühlen, Christoph Bode, Peter Stachon
OBJECTIVES: The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). BACKGROUND: A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. METHODS: In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27694795/valve-in-valve-replacement-using-a-sutureless-aortic-valve
#20
Pascal M Dohmen, Lukas Lehmkuhl, Michael A Borger, Martin Misfeld, Friedrich W Mohr
BACKGROUND We present a unique case of a 61-year-old female patient with homograft deterioration after redo surgery for prosthetic valve endocarditis with root abscess. CASE REPORT The first operation was performed for type A dissection with root, arch, and elephant trunk replacement of the thoracic aorta. The present re-redo surgery was performed as valve-in-valve with a sutureless aortic bioprosthesis. The postoperative course was uneventful and the patient was discharged on day 6. CONCLUSIONS The current case report demonstrates that sutureless bioprostheses are an attractive option for surgical valve-in-valve procedures, which can reduce morbidity and mortality...
October 3, 2016: American Journal of Case Reports
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