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Valve sparing

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https://www.readbyqxmd.com/read/28427597/intentional-percutaneous-laceration-of%C3%A2-the%C3%A2-anterior-mitral-leaflet-to-prevent%C3%A2-outflow%C3%A2-obstruction-during-transcatheter-mitral-valve-replacement-first-in-human%C3%A2-experience
#1
Vasilis C Babaliaros, Adam B Greenbaum, Jaffar M Khan, Toby Rogers, Dee Dee Wang, Marvin H Eng, William W O'Neill, Gaetano Paone, Vinod H Thourani, Stamatios Lerakis, Dennis W Kim, Marcus Y Chen, Robert J Lederman
OBJECTIVES: This study sought to use a new catheter technique to split the anterior mitral valve leaflet (AML) and prevent iatrogenic left ventricular outflow tract (LVOT) obstruction immediately before transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a life-threatening complication of TMVR, caused by septal displacement of the AML. METHODS: The procedure was used in patients with severe mitral valve disease and prohibitive surgical risk...
April 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28379458/mid-term-results-of-bicuspid-aortic-valve-repair-guided-by-morphology-and-function-assessment
#2
Khalil Fattouch, Marco Moscarelli, Sebastiano Castrovinci, Giacomo Murana, Pietro Dioguardi, Francesco Guccione, Giuseppe Nasso, Giuseppe Speziale, Patrizio Lancellotti
OBJECTIVES: Bicuspid aortic valve (BAV) is frequently associated with aortic insufficiency (AI) due to cusp disease and/or aortic root dilatation. Based on functional classification and morphology, a systematic surgical approach was used for aortic valve repair (AVr). METHODS: : From 2004 to 2014, 152 consecutive patients (mean age 55 ± 7 years) with BAV underwent AVr with or without concomitant aortic root surgery. Cusp pathology was treated with central plication in 60 (39...
April 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28366467/aortic-root-replacement-for-children-with-loeys-dietz-syndrome
#3
Nishant D Patel, Diane Alejo, Todd Crawford, Narutoshi Hibino, Harry C Dietz, Duke E Cameron, Luca A Vricella
BACKGROUND: Loeys-Dietz syndrome (LDS) is an aggressive aortopathy with a proclivity for aortic aneurysm rupture and dissection at smaller diameters than other connective tissue disorders. We reviewed our surgical experience of children with LDS to validate our guidelines for prophylactic aortic root replacement (ARR). METHODS: We reviewed all children (younger than 18 years) with a diagnosis of LDS who underwent ARR at our institution. The primary endpoint was mortality, and secondary endpoints included complications and the need for further interventions...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359486/intraoperative-bioprosthetic-valve-dysfunction-causing-severe-mitral-regurgitation
#4
Philip Y K Pang, Susan Garwood, Sabet W Hashim
Structural degeneration of bioprosthetic valves usually occurs gradually over time. Failure of a bioprosthetic valve immediately after implantation is extremely rare. Possible causes include obstruction of valve leaflets from preserved subvalvular tissue during chordal-sparing mitral valve replacement (MVR) or strut entrapment by suture loops. We report 2 cases of acute bioprosthetic mitral valve (MV) dysfunction involving newly implanted Perimount Theon (Edwards Lifesciences, Irvine, CA) bioprostheses, causing severe transvalvular mitral regurgitation (MR)...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28355759/-clinical-practice-and-thoughts-on-the-strategy-of-root-reconstruction-for-stanford-type-a-aortic-dissection
#5
C S Wang, J Li, H Lai
The strategy of root reconstruction for Stanford type A aortic dissection (AAD) includes resection of the intimal tear site, correction of concomitant aortic valve dysfunction and amendment of coronary lesion. Supracommissural tube graft replacement is a well-adopted and convenient procedure for most patients, although its application is limited when distinct sinus expansion and severe intimal damage is present. Composite valve conduit replacement (Bentall procedure) is suitable for patients with overt sinus damage...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#6
Elizabeth H Stephens, Jennifer Tingo, Marc Najjar, Betul Yilmaz, Stéphanie Levasseur, Jeffrey D Dayton, Ralph S Mosca, Paul Chai, Jan M Quaegebeur, Emile A Bacha
BACKGROUND: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention. METHODS: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329237/extensive-infective-endocarditis-of-the-aortic-root-and-the-aortic-mitral-continuity-a-mitral-valve-sparing-approach%C3%A2
#7
Anton Tomšic, Adriaan W Schneider, Meindert Palmen, Thomas J van Brakel, Michel I M Versteegh, Robert J M Klautz
OBJECTIVES: Severe cases of infective endocarditis (IE) of the aortic valve can cause aortic root destruction and affect the surrounding structures, including the aortic-mitral continuity, the anterior mitral valve leaflet and the roof of the left atrium. Reconstruction after resection of all infected tissue remains challenging. We describe our surgical approach and the mid-term results. METHODS: Between January 2004 and December 2015, 35 patients underwent surgery for extensive IE of the aortic valve with destruction of the aortic root, the aortic-mitral continuity and the mitral valve...
February 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329232/mid-term-results-of-bilateral-lung-transplant-with-postoperatively-extended-intraoperative-extracorporeal-membrane-oxygenation-for-severe-pulmonary-hypertension%C3%A2
#8
Jawad Salman, Fabio Ius, Wiebke Sommer, Thierry Siemeni, Christian Kuehn, Murat Avsar, Dietmar Boethig, Ulrich Molitoris, Christoph Bara, Jens Gottlieb, Tobias Welte, Axel Haverich, Marius M Hoeper, Gregor Warnecke, Igor Tudorache
OBJECTIVES: In severe pulmonary hypertension, diastolic dysfunction of the left ventricle causes significant morbidity and mortality after lung transplantation, which may be successfully reversed using a protocol based on perioperative veno-arterial extracorporeal membrane oxygenation (ECMO) and early extubation. Here, we present echocardiographic data and mid-term outcomes. METHODS: The records of lung transplanted patients at our institution between May 2010 and January 2016 were retrospectively reviewed...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329094/biological-solutions-to-aortic-root-replacement-valve-sparing-versus-bioprosthetic-conduit%C3%A2
#9
Mario Gaudino, Antonino Di Franco, Lucas B Ohmes, Luca Weltert, Christopher Lau, Ivancarmine Gambardella, Andrea Salica, Monica Munjal, Mohamed Elsayed, Leonard N Girardi, Ruggero De Paulis
OBJECTIVES: Valve-sparing operations and root replacement with a biologic composite conduit are viable options in aortic root aneurysm. This study was conceived to compare the early and mid-term results of these 2 procedures. METHODS: From September 2002 to November 2015, 749 consecutive patients underwent either a valve-sparing operation or a root replacement with a biologic composite conduit at 2 institutions. Propensity score matching was used to compare similar cohorts of patients in the overall population and in the ≤ 55 and ≥ 65-year age groups...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28320511/malrotated-sinus-vortices-in-straight-graft-valve-sparing-aortic-root-treatment-a-matter-of-concern
#10
EDITORIAL
Thekla H Oechtering, Alex Frydrychowicz, Hans-Hinrich Sievers
No abstract text is available yet for this article.
February 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28281042/valve-sparing-aortic-root-re-implantation-for-commissural-detachment-with-fibrous-strand
#11
Seiji Matsukuma, Taku Inoue, Kazuyoshi Tanigawa, Takashi Miura, Ichiro Matsumaru, Mizuki Sumi, Takeshi Murakami, Kikuko Obase, Kiyoyuki Eishi
Both aortic valve commissural detachment and commissural fenestration are rare causes of aortic regurgitation. In general, aortic valve replacement is the mainstay treatment for aortic regurgitation caused by commissural detachment or commissural fenestration. We herein describe valve-sparing aortic root re-implantation and aortic valve repair for aortic regurgitation and aortic root dilatation in an extremely rare case accompanied by both commissural detachment and commissural fibrous strand of fenestrated cusp...
March 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28269006/prediction-of-individual-prosthesis-size-for-valve-sparing-aortic-root-reconstruction-based-on-geometric-features
#12
J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner
Valve-sparing aortic root reconstruction is an up- and-coming approach for patients suffering from aortic valve insufficiencies which promises to significantly reduce complications. However, the success of the treatment strongly depends on the challenging task of choosing the correct size of the prosthesis, for which, up to now, surgeons solely have to rely on their experience. Here, we present a novel machine learning based approach, which might make it possible to predict the size of the prosthesis from pre-operatively acquired ultrasound images...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268005/feasibility-of-intraoperative-water-testing-in-aortic-valve-repair-direct-visualization-from-left-ventricle-with-a-videoscope
#13
Shunsuke Miyahara, Takanori Oka, Hiroaki Takahashi, Takeshi Inoue, Masamichi Matsumori, Hiroshi Tanaka, Yutaka Okita
OBJECTIVE: We describe a simple method to assess the aortic valve using a videoscope inserted in the left ventricle (LV-VS) during valve-sparing root replacement. The aim of this study was to evaluate the feasibility of this technique by comparing it with the findings of postoperative transesophageal echocardiography (TEE). METHODS: Thirty-six patients (29 male, mean age 45.4 ± 20.1 years) undergoing aortic root reimplantation were assessed intraoperatively with LV-VS...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28259111/evidence-based-surgery-of-aortic-regurgitation-results-of-a-questionnaire-in-german-speaking-countries
#14
Christian Dinges, Johannes Steindl, Wolfgang Hitzl, Tobias Kiesslich, Rainald Seitelberger
Background evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve...
March 4, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28229270/should-the-annulus-be-fixed-in-aortic-valve-sparing-root-replacement-with-remodeling
#15
Kojiro Furukawa, Keiji Kamohara, Junji Yunoki, Shugo Koga, Manabu Itoh, Hiroyuki Morokuma, Yosuke Mukae, Tsuyoshi Itoh, Shigeki Morita
OBJECTIVES: If the aortic root dilates after native aortic valve-sparing root reconstruction with remodeling, aortic regurgitation may recur. However, it has not been demonstrated clearly that the aortic root dilates after remodeling. METHODS: This study enrolled 15 patients who underwent an aortic valve-sparing operation with remodeling (2002-2014) but without any ventriculo-aortic junction (VAJ) fixation. Technically, special care was taken to pass the sutures through the fibrous annulus...
April 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28227216/prediction-of-individual-prosthesis-size-for-valve-sparing-aortic-root-reconstruction-based-on-geometric-features
#16
J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner, J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner, C Metzner, E Werrmann, J Hagenah, F Ernst, M Scharfschwerdt
Valve-sparing aortic root reconstruction is an up- and-coming approach for patients suffering from aortic valve insufficiencies which promises to significantly reduce complications. However, the success of the treatment strongly depends on the challenging task of choosing the correct size of the prosthesis, for which, up to now, surgeons solely have to rely on their experience. Here, we present a novel machine learning based approach, which might make it possible to predict the size of the prosthesis from pre-operatively acquired ultrasound images...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28187973/remodeling-root-repair-with-an-external-aortic-ring-annuloplasty
#17
Emmanuel Lansac, Isabelle Di Centa, Ghassan Sleilaty, Stephanie Lejeune, Alain Berrebi, Pavel Zacek, Mathieu Debauchez
OBJECTIVE: Although the remodeling technique provides the most dynamic valve-sparing root replacement, a dilated annulus (>25 mm) is a risk factor for failure. Aortic annuloplasty aims to reduce the annulus diameter, thus increasing coaptation height to protect the repair. The results of 177 patients with remodeling and external aortic ring annuloplasty were studied. METHODS: Data were collected from the Aortic Valve repair InternATiOnal Registry. Preoperative aortic insufficiency grade 3 or greater was present in 79 patients (44...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#18
Neil Parikh, Santi Trimarchi, Thomas G Gleason, Arnoud V Kamman, Marco di Eusanio, Truls Myrmel, Amit Korach, Hersh Maniar, Takeyoshi Ota, Ali Khoynezhad, Daniel G Montgomery, Nimesh D Desai, Kim A Eagle, Christoph A Nienaber, Eric M Isselbacher, Joseph Bavaria, Thoralf M Sundt, Himanshu J Patel
OBJECTIVE: Advancements in cardiothoracic surgery prompted investigation into changes in operative management for acute type A aortic dissections over time. METHODS: One thousand seven hundred thirty-two patients undergoing surgery for type A aortic dissection were identified from the International Registry of Acute Aortic Dissection Interventional Cohort Database. Patients were divided into time tertiles (T) (T1: 1996-2003, T2: 2004-2010, and T3: 2011-2016). RESULTS: Frequency of valve sparing procures increased (T1: 3...
January 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28134020/femoral-vein-valve-incompetence-as-a-risk-factor-for-junctional-recurrence
#19
Sergio Gianesini, Savino Occhionorelli, Erica Menegatti, Anna Maria Malagoni, Mirko Tessari, Paolo Zamboni
Background Recurrent varicose veins occur up to 80% of procedures. The sapheno-femoral junction can be involved in more than 50% of cases. A detailed pathophysiological explanation of the phenomenon is still missing. The aim of the present work is to evaluate the role of femoral vein incompetence as risk factor for sapheno-femoral junction recurrence. Methods Three-hundred-eighty-one patients presenting an incompetent great saphenous vein system and eventually also an incompetent femoral tract (C2-6EpAsdPr) underwent a great saphenous vein high ligation with flush ligation also of the incompetent tributaries along the leg, sparing the saphenous trunk...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28109394/lead-sparing-tricuspid-valve-repair-damaged-by-pacemaker-lead
#20
Kasra Shaikhrezai, Aleksandra Bartnik, Maziar Khorsandi, Steven Hunter
Permanent pacemaker lead may damage the tricuspid valve in various ways, causing severe tricuspid valve regurgitation. The perforation of posterior papillary muscle is an uncommon complication caused by the lead. We describe a lead-sparing tricuspid valve repair in which the lead extraction was not an option. The papillary muscle containing the lead was fully mobilized to release the adherent leaflets. The repair was completed by commissuroplasty as well as ring annuloplasty, leaving the lead inside the implanted ring...
February 2017: Annals of Thoracic Surgery
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