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Valve sparing

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https://www.readbyqxmd.com/read/28229270/should-the-annulus-be-fixed-in-aortic-valve-sparing-root-replacement-with-remodeling
#1
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...
February 22, 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
#2
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
#3
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...
January 11, 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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#7
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28058268/early-results-of-a-novel-mitral-valve-repair-procedure-the-interpapillary-polytetrafluoroethylene-bridge-formation
#8
Nasri Alotti, Károly Gombocz, Kiddy L Ume, Amer Sayour, Daniel Alejandro Lerman, Aref Rashed
BACKGROUND: Surgical repair of ischemic mitral regurgitation (IMR) associated with chordal rupture in patients with ischemic cardiomyopathy is challenging as it aims to correct several structural pathologies at once. There are ongoing studies evaluating multiple approaches, however long term results are still scarce. METHODS AND RESULTS: 19 patients with IMR underwent mitral valve repair with interpapillary polytetrafluoroethylene (PTFE) bridge and neochordae formation at the Zala County Teaching Hospital...
February 12, 2016: International Journal of Cardiovascular Research
https://www.readbyqxmd.com/read/28043991/partial-root-remodelling-for-treatment-of-a-giant-isolated-right-sinus-of-valsalva-aneurysm
#9
Makoto Hashimoto, Hirosato Doi, Ryuji Koshima, Satoshi Sumino
Sinus of Valsalva aneurysms are rare cardiac abnormalities that may be congenital or acquired. Patch closure or direct closure of the aneurysm orifice is a frequently performed surgical repair strategy. In this report, we present a rare case of an isolated giant right sinus of Valsalva aneurysm with aortic insufficiency and right coronary artery obstruction. We treated this patient by a valve-sparing aortic root remodelling procedure with partial preservation of the intact Valsalva sinuses and coronary artery bypass grafting with a favourable outcome...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#10
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040766/valve-sparing-aortic-root-replacement-for-a-prolapsing-asymmetric-valve
#11
Daisuke Takahashi, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita
Valve-sparing aortic root replacement remains challenging for patients with eccentric severe aortic regurgitation when the cusps are totally asymmetric. We report a case of successful reimplantation operation for such a lesion. Because free margin lengths from commissure to Arantius body of the adjacent two cusps were matched while inter-commissural distances were totally different, right coronary cusp prolapse was corrected by asymmetrically aligning the position and height of three commissures without cusp plication...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040763/feasibility-and-clinical-outcome-after-minimally-invasive-valve-sparing-aortic-root-replacement
#12
Kristina Wachter, Ulrich F W Franke, Rashmi Yadav, Ragi Nagib, Adrian Ursulescu, Samir Ahad, Hardy Baumbach
OBJECTIVES: This study aims to examine the feasibility and clinical course after minimally invasive David procedure compared with those via a conventional median sternotomy. METHODS: One hundred and ninety-two consecutive patients who underwent elective valve-sparing aortic root replacement (David procedure) with or without additional cusp repair for aortic regurgitation (n = 17, 8.9%), dilatation of the aortic root (n = 95, 49.5%) or a combination of both pathologies (n = 80, 41...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28009957/implantation-of-a-sapien-3-valve-in-a-patient-with-pure-aortic-regurgitation
#13
Jan-Philipp Minol, Verena Veulemans, Tobias Zeus, Alexander Blehm
Transcatheter aortic valve implantation (TAVI) is an emerging treatment for high-risk patients with aortic stenosis. Aortic regurgitation is considered to be a relative contraindication for transcatheter procedures, as a non-calcified aortic annulus poses the risk of an insufficient anchoring of the transcatheter aortic valve prosthesis. Herein is described the case of a patient who suffered from recurrent aortic valve regurgitation after valve-sparing repair, and which was successfully treated by the transcatheter implantation of an Edwards SAPIEN 3™ prosthesis...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009953/mitral-valve-re-repair-in-an-adult-patient-having-undergone-mitral-ring-annuloplasty-at-five-years-of-age
#14
Jong Hun Kim, Tae Youn Kim, Jong Bum Choi, Ja Hong Kuh
In adult patients who have undergone mitral annuloplasty with a rigid ring at a young age, the mitral valve may ultimately deform and demonstrate insufficient growth because the valve annulus is fixed to the ring. Mitral valve re-repair, following this scenario, was performed for mitral stenoinsufficiency in a 26-year-old female patient who had undergone mitral annuloplasty with a rigid ring at the age of five years. The valve re-repair procedure consisted of decalcification and stripping of the anterior leaflet and annulus, posterior leaflet augmentation using an elliptical autologous pericardial patch, and a posterior strip annuloplasty sparing the anterior annulus and commissures...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009040/bilateral-progressive-coronary-ostial-stenosis-following-valve-sparing-aortic-root-replacement
#15
Adam Rdzanek, Paweł Czub, Piotr Ścisło, Jolanta Stanisławska-Nielepkiewicz, Janusz Kochman
No abstract text is available yet for this article.
2016: Kardiologia Polska
https://www.readbyqxmd.com/read/28007071/valve-sparing-or-valve-reconstruction-options-in-tetralogy-of-fallot-surgery
#16
REVIEW
Emile Bacha
This review deals with a relatively new field in congenital heart surgery, valve preservation or, in cases of more severe pulmonary valve stenosis or dysplasia, valve reconstruction during tetralogy of Fallot repair. We describe the stepwise approach utilized, starting with simple maneuvers such as commissurotomy and valve dilation for mild pulmonary stenosis to commissurotomy and intraoperative balloon dilation for moderate stenosis, and finally transection of the annulus and valve reconstruction using a patch that acts as a modified monocusp...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/28007066/valve-sparing-aortic-root-replacement-in-pediatric-patients-lessons-learned-over-two-decades
#17
REVIEW
Luca A Vricella, Duke E Cameron
Valve-sparing aortic root replacement has been utilized in children with aneurysms of the proximal aorta as a valid alternative to composite mechanical or biologic prostheses. While the majority of pediatric patients with aortic root aneurysms have various forms of connective tissue disorders, other diagnostic groups have emerged, such as patients with various forms of congenital heart disease and non-syndromic thoracic aortic aneurysms. We present our experience with valve-sparing procedures in pediatric patients, highlighting the technical aspects of the operation as well as some of the pitfalls and complications we have encountered over the last two decades...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27989095/quadruple-valve-reoperation-after-the-ross-procedure
#18
Nora Goebel, Marc Albert, Alina Stan, Adrian Ursulescu, Ulrich F W Franke
Reoperations after the Ross procedure are rare, with autograft as well as homograft failure being the dominant causes for redo cardiac procedures. Due to increasing experience with valve-sparing aortic valve procedures, more valves can be preserved during redo surgery. Herein are reported the details of a patient who underwent quadruple valve reoperation comprising redo with a reconstructive approach after the short-term failure of pulmonary autograft and homograft with concomitant mitral and tricuspid regurgitation...
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27966257/twenty-five-year-outcomes-following-composite-graft-aortic-root-replacement
#19
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/27965932/valve-sparing-root-replacement-aortic-root-remodeling-with-external-subvalvular-ring-annuloplasty
#20
Sang-Ho Cho, Dae Hyun Kim, Young Tae Kwak
The original valve-sparing procedures for aortic root aneurysms were remodeling and reimplantation of the aortic root. The remodeling technique provides more physiologic movement of the cusps within 3 reconstructed neo-sinuses, thus preserving root expansibility through the interleaflet triangles. However, the durability of remodeling has been a matter of concern due to the high rate of aortic insufficiency when annular dilation is not addressed. Therefore, a modified approach was developed, combining a physiologic remodeling of the root with a subvalvular annuloplasty...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
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