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Valve sparing

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https://www.readbyqxmd.com/read/28633260/total-chordal-sparing-mitral-valve-replacement-in-rheumatic-disease-a-word-of-caution
#1
Samuel M Kessel, Robert B Hawkins, Leora T Yarboro, Gorav Ailawadi
Total chordal preservation is the standard for mitral valve replacement to maintain long-term left ventricular geometry. Whereas it is appropriate for functional and degenerative mitral regurgitation, the role of chordal sparing in rheumatic valve disease is less well understood, with limited evidence supporting total chordal sparing. Inasmuch as this autoimmune disease affects the subvalvular apparatus in addition to the leaflets, it can be expected to continue after surgical repair. Here we present 2 patients who experienced adverse events associated with total chordal sparing mitral replacement as a result of disease progression with rapid fibrous growth causing inflow obstruction and early prosthetic valve failure...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28629660/characterization-and-risk-factors-for-aortic-dilatation-in-pediatric-patients-with-bicuspid-aortic-valve
#2
Anna Sabaté-Rotés, Laura Sabidó Sanchez, Ferran Gran Ipiña, Dimpna Albert Brotons, Raúl F Abella, Ferran Rosés Noguer
INTRODUCTION AND OBJECTIVES: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. METHODS: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17)...
June 16, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28616349/sparing-aortic-valve-techniques
#3
Rubén Álvarez-Cabo
Prosthetic valve implantation is the most widely used therapeutic option for aortic regurgitation (AR), but complications associated with prosthetic valves, with an incidence of 3-5% patient/year, and the need for anticoagulation in mechanical valves, force us to consider aortic valve repair as an alternative to the prosthetic implant, especially in young people with many potential years of life for these complications. Aortic valve repair techniques are not excessively complicated, but there is no standardization, so they are not reproducible in all medical centers...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#4
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28606209/massive-aortic-root-aneurysm-in-an-infant-with-the-loeys-dietz-syndrome
#5
Tatiana Molina-Sánchez, Juan Calderón-Colmenero, Juan Pablo Sandoval
A 10-month-old girl with type I Loeys-Dietz syndrome developed a conspicuous aortic root aneurysm that was well demonstrated on chest X-ray/CT reconstruction. She underwent successful valve-spare repair of the ascending aorta.
June 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#6
Christine H Attenhofer Jost, Heidi M Connolly, Christopher G Scott, Naser M Ammash, Juan M Bowen, Hartzell V Schaff
BACKGROUND: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). METHODS: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. RESULTS: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7)...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28543757/transcatheter-aortic-valve-replacement-for-a-bicuspid-aortic-valve-following-replacement-of-the-ascending-aorta
#7
Paolo Nardi, Marco Russo, Guglielmo Saitto, Gian Paolo Ussia, Giovanni Ruvolo
A normally functioning bicuspid aortic valve that is spared during replacement of the ascending aorta may ultimately require replacement due to structural deterioration. We report the use of trans-aortic valve replacement to replace a stenotic BAC 17 years following replacement of the ascending aorta.
May 21, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#8
Kirsten Krohg-Sørensen, Per Snorre Lingaas, Runar Lundblad, Egil Seem, Benedicte Paus, Odd R Geiran
OBJECTIVES: The first publication of Loeys-Dietz syndrome (LDS) described aortic rupture at young ages. Experience with new LDS types showed that the clinical course varies, and thresholds for prophylactic surgery are discussed. As this is an uncommon disease, experience needs to be shared. METHODS: Retrospective review of patients with LDS types 1-4 undergoing cardiovascular surgery during the years 1991-2016. RESULTS: Thirty-five patients (including 6 children with LDS2) underwent 57 operations...
May 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28527766/successful-transcatheter-aortic-valve-replacement-for-severe-aortic-valve-regurgitation-following-a-david-i-valve-sparing-procedure
#9
Edgar Lik-Wui Tay, William Kok-Fai Kong, James Wei-Luen Yip, Ting Ting Low, Jimmy Kim-Fatt Hon
No abstract text is available yet for this article.
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28516095/david-v-procedure-in-a-patient-with-aortic-dilation-and-competent-quadricuspid-aortic-valve-are-genetics-to-blame
#10
Katherine R Hebeler, John J Squiers, Heike Baumgarten, J Michael DiMaio, William T Brinkman
Quadricuspid aortic valves (QAVs) are extremely rare. In this case study, we report a David-V valve-sparing aortic root replacement with reimplantation of a native QAV in a patient with aortic dilation, normal valve function, and a family history of aortic dissection. Microscopic pathological examination of the excised section of the aorta revealed scattered small foci of cystic medical degeneration throughout. A genetic predisposition for aortic dilation may be present in patients with QAV, even in the setting of a competent valve...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28508532/aortic-valve-replacement-for-papillary-fibroelastoma
#11
REVIEW
Ali Ahmet Arikan, Oğuz Omay, Fatih Aydın, Muhip Kanko, Sibel Gür, Emir Derviş, Cansu Eda Yılmaz, Bahar Müezzinoğlu
Surgery is indicated for symptomatic patients with papillary fibroelastomas (PFE) on the aortic valve. The valve is commonly spared during tumor excision. Rarely, aortic valve replacement (AVR) is needed. We present a case requiring AVR for an aortic valve PFE and review the literature to determine the risk factors for failure of aortic valve-sparing techniques in patients with PFE.
May 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28492719/does-aortic-valve-repair-in-valve-sparing-aortic-root-reconstruction-compromise-the-longevity-of-the-procedure
#12
Ricardo Ribeiro Dias, José Augusto Duncan, Fabrício José de Souza Dinato, Lucas Lacerda Araújo, Hugo Monteiro Neder Issa, Fábio Fernandes, Charles Mady, Fábio Biscegli Jatene
OBJECTIVES: The effect of performing aortic valve repair in combination with valve-sparing operation on the length of time for which patients are free from reoperation is unclear. The objective of this study was to determine if the performance of aortic valve repair during valve-sparing operation modified the freedom from reoperation time. METHODS: From January 2003 to July 2014, 78 patients with a mean age of 49±15 years underwent valve-sparing operation. Sixty-eight percent of these patients were male...
April 2017: Clinics
https://www.readbyqxmd.com/read/28485110/the-role-of-neo-sinus-reconstruction-in-aortic-valve-sparing-surgery
#13
Mario Gaudino, Antonino Di Franco, Luca Weltert, Umberto Benedetto, Christopher Lau, Ivancarmine Gambardella, Ruggero De Paulis, Leonard N Girardi
AIMS: The aim of this study was to evaluate the clinical and echocardiographic results and the predictors of outcomes in patients undergoing valve-sparing operation (VSO) at two aortic centers. In addition, we sought to evaluate the potential effect of recreation of the sinuses of Valsalva (SV) on the outcome of valve-sparing procedures. METHODS: During a 14-year period, 328 patients underwent aortic valve-sparing root replacement at two institutions. Clinical and echo evaluation was performed 6 months after surgery and every year thereafter or in case of clinical symptoms...
May 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28465967/late-echocardiographic-study-of-aortic-valve-and-aortic-root-after-surgery-for-type-a-acute-aortic-dissection
#14
Martina Molteni, Benedetta De Chiara, Francesca Casadei, Luca Botta, Bruno Merlanti, Claudio Francesco Russo, Cristina Giannattasio, Antonella Moreo
OBJECTIVE: In case of concomitant aortic regurgitation (AR) valve, sparing operation is considered the first choice in selected patients. The aim of this retrospective clinical and echocardiographic study was to evaluate the long-term survival results of conservative approach and the determinants of recurrent AR. METHODS: From 2000 to 2011, fifty patients (median: 63 years and interquartile range: 53-72) underwent an aortic valve-sparing procedure for acute aortic dissection, and discharged alive...
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28461803/autologous-pericardial-patch-repair-for-papillary-fibroelastoma-on-an-aortic-valve-leaflet
#15
Tomoki Sakata, Mitsuru Nakaya, Masayoshi Otsu, Toru Sunazawa, Yutaka Wakabayashi
A 50-year-old man with no history of cardiovascular disease was referred to our hospital because of an abnormal electrocardiogram. Echocardiograms and computed tomograms revealed a 9-mm mass on the underside of an aortic valve leaflet. We chose surgical treatment, to prevent embolic events. The tumor's appearance and intraoperative frozen section were consistent with myxoma. We resected the tumor and its attachment, including the free margin of the aortic valve leaflet, and repaired the defect with use of a glutaraldehyde-treated autologous pericardial patch...
April 2017: Texas Heart Institute Journal
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
#16
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
#17
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
#18
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...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359486/intraoperative-bioprosthetic-valve-dysfunction-causing-severe-mitral-regurgitation
#19
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
#20
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]
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