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Valve sparing

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https://www.readbyqxmd.com/read/29049790/sinus-of-valsalva-aneurysms-with-concomitant-aortic-insufficiency-how-should-the-aortic-valve-be-managed
#1
Yi Lin, Kanhua Yin, Yulin Wang, Changfa Guo, Ziwei Tian, Qiuchen Xie, Zhiqi Zhang, Chunsheng Wang
OBJECTIVES: Sinus of Valsalva aneurysms (SVAs) are rare and are often complicated by aortic insufficiency (AI). Treating AI is important for achieving good long-term results in patients with SVA. Here, we have summarized our experience with the surgical management of patients with SVA with concomitant AI. METHODS: Patients who were diagnosed with SVA and underwent surgical treatment between January 2008 and May 2016 were included. Clinical characteristics, including age, gender, SVA anatomy and concurrent anomalies, were analysed...
September 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046487/autograft-valve-sparing-root-replacement-for-late-ross-failure-during-quadruple-valve-surgery
#2
Andrew B Goldstone, Christopher W Jensen, Mary Sheridan Bilbao, Y Joseph Woo
Approximately 25% of patients require reoperation within 15 yrs of a Ross procedure. Increasing experience with valve-sparing root replacement (VSRR) has led some surgeons to spare the autograft valve. Here, we demonstrate that all valves can be surgically repaired or replaced safely during autograft VSRR. As more patients are considered for this operation, coexistent mitral, tricuspid, and pulmonic valve dysfunction should not preclude salvage of the autograft valve, nor should autograft leaflet prolapse.
October 17, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29026988/pulmonary-annular-motion-velocity-reflects-right-ventricular-outflow-tract-function-in-children-with-surgically-repaired-congenital-heart-disease
#3
Yasunobu Hayabuchi, Akemi Ono, Yukako Homma, Shoji Kagami
Right ventricular (RV) dysfunction is generally evaluated using analyses of tricuspid annular motion. However, it represents only one aspect of RV performance. Whether measuring pulmonary annular motion velocity could serve as a novel way to evaluate global RV and/or RV outflow tract (RVOT) performance in pediatric congenital heart disease (CHD) patients with surgically repaired RVOT was evaluated. In this prospective study, tissue Doppler-derived pulmonary annular motion velocity was measured in children (aged 2-5 years) with RVOT reconstruction (RVOTR group, n = 48) and age-matched healthy children (Control, n = 60)...
October 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29019069/pro-con-debate-valve-sparing-aortic-root-surgery-pro-reimplantation
#4
Ruggero De Paulis
The remodeling and the reimplantation procedures were described more than 25 years ago with the aim of sparing, otherwise normal aortic valve in the presence of a root aneurysm. Because of its ability to reconstruct the sinuses of Valsalva, the remodeling procedure was considered to be more physiological than the reimplantation. However, because the remodeling lacked annular stabilization, the long-term stability of the procedure was questioned. However, through the years, both procedures have been significantly improved, so that is now possible to perform a reimplantation procedure with neo-sinuses reconstruction or a remodeling procedure with annular stabilization...
October 10, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28962499/valve-sparing-aortic-root-replacement-in-a-bicuspid-aortic-valve-with-papillary-fibroelastoma
#5
Stoyan Kondov, Fabian Alexander Kari, Martin Czerny, Matthias Siepe
We present our surgical strategy in a patient with a bicuspid aortic valve Type I (R/N), aortic root aneurysm and papillary fibroelastoma on the aortic valve's cusp. He underwent valve-sparing aortic root replacement (David V Procedure); we also removed the papillary fibroelastoma from the fused right- and non-coronary cusp. In this case, we used a 34-mm straight Dacron graft for root replacement and an aortic annulus downsized to 30 mm. We use Hegar dilatators for the intraoperative measurement of the aortic annulus...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958079/management-of-foetal-circulation-by-switching-to-pulsatile-perfusion-during-cardiovascular-surgery-in-pregnancy
#6
Kenta Masada, Kazuo Shimamura, Toru Kuratani, Yoshiki Sawa
Cardiovascular surgery with cardiopulmonary bypass during pregnancy is associated with high foetal mortality. The foetal heart rate should be monitored, because foetal circulation is rate dependent, and experimental evidence supports the efficacy of pulsatile perfusion. We describe a novel foetal monitoring technique and successful foetal heart rate control by switching non-pulsatile to pulsatile perfusion in a 43-year-old woman with a sinus of Valsalva aneurysm who underwent valve-sparing partial aortic root remodelling at 18 weeks of gestation...
September 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28918516/valve-sparing-aortic-root-surgery-con-remodeling
#7
Takashi Kunihara
The two major valve-sparing root replacement procedures, aortic valve reimplantation (reimplantation) and aortic root remodeling (remodeling), have advantages and disadvantages, which are reviewed herein. The main advantage of reimplantation is the resulting annular support, and the disadvantages are the unfavorable hemodynamics and relatively long procedure time. The main advantages of remodeling are the physiological hemodynamics and decreased procedure time, and the disadvantage is the lack of annular support...
September 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28868309/aortic-root-reconstruction-with-a-new-dacron-graft-featuring-prefabricated-coronary-side-branches-lessons-learned-from-the-cabrol-procedure
#8
Domenico Calcaterra, Mohammad-Ali Jazayeri, Joseph W Turek, Kalpaj R Parekh, Mohammad Bashir, Karam Karam, Robert S Farivar
BACKGROUND: Coronary button reimplantation can represent a technical challenge of aortic root reconstruction that can be associated with significant morbidity and mortality. With the goal of simplifying coronary reimplantation and reducing the incidence of related complications, we designed a new Dacron graft with prefabricated coronary branches to minimize coronary artery mobilization and prevent the potential mechanical complications of reattachment to the body of the graft. METHODS: Between June 2010 and May 2012, we implanted the graft in eight patients (six males, two females) ranging in age from 42-68 years (mean, 54 years)...
February 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28864719/anatomical-and-clinical-predictors-of-valve-dysfunction-and-aortic-dilation-in-bicuspid-aortic-valve-disease
#9
Arturo Evangelista, Pastora Gallego, Francisco Calvo-Iglesias, Javier Bermejo, Juan Robledo-Carmona, Violeta Sánchez, Daniel Saura, Roman Arnold, Amelia Carro, Giuliana Maldonado, Augusto Sao-Avilés, Gisela Teixidó, Laura Galian, José Rodríguez-Palomares, David García-Dorado
OBJECTIVE: Bicuspid aortic valve (BAV) is associated with early valvular dysfunction and proximal aorta dilation with high heterogeneity. This study aimed to assess the determinants of these complications. METHODS: Eight hundred and fifty-two consecutive adults diagnosed of BAV referred from cardiac outpatient clinics to eight echocardiographic laboratories of tertiary hospitals were prospectively recruited. Exclusion criteria were aortic coarctation, other congenital disorders or intervention...
September 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28838101/valve-sparing-david-i-procedure-in-acute-aortic-type-a-dissection-a-20-year-experience-with-more-than-100-patients
#10
Erik Beckmann, Andreas Martens, Jana Pertz, Tim Kaufeld, Julia Umminger, Jasmin S Hanke, Jan D Schmitto, Serghei Cebotari, Axel Haverich, Malakh Lal Shrestha
OBJECTIVES: The aortic valve-sparing David procedure has been applied to the elective treatment of patients with aortic aneurysms with excellent results. The use of this technique in patients with acute aortic dissection type A (AADA) is still a matter of debate. We present our long-term experience with 109 patients with AADA who had the valve-sparing David I procedure. METHODS: Between July 1993 and October 2015, 109 patients with AADA had the valve-sparing David I procedure at our centre...
August 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#11
Yujiro Ito, Yoshitsugu Nakamura, Miho Kuroda, Yuki Endo, Yusuke Nakanishi, Takaki Hori
Circumferential dissection is a rare clinical condition of aortic dissection, which is also known as intimo-intimal intussusception. In patients with type A aortic dissection with intimo-intimal intussusception, disruption and prolapse of the intimal flap into the left ventricle may occur and cause severe aortic regurgitation or blockage of the coronary artery ostium. A 43-year-old man presented with sudden dyspnea. Echocardiography revealed severe aortic insufficiency. Acute coronary syndrome was also suspected, but coronary angiography showed normal coronary arteries...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28779858/transfemoral-transcatheter-aortic-valve-implantation-for-treatment-of-severe-aortic-regurgitation-in-a-patient-with-previous-aortic-valve-sparing-operation-according-to-david
#12
Luca Favero, Alessandro De Leo, Alessandro Daniotti, Diego Calzolari, Nicola Gasparetto, Giuseppe Minniti, Elvio Polesel, Zoran Olivari
The regurgitation of the native aortic valve in patient with previous David operation may represent a clinical challenge because the morbidity and mortality risk of re-operation is not negligible. Here we describe the case of a patient suffering from late severe aortic regurgitation, many years after David operation, efficaciously treated with transfemoral transcatheter aortic valve implantation. To the best of our knowledge, this is the first description of such treatment in a patient with aortic regurgitation and previous David operation...
July 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28759513/importance-of-early-detection-and-cardiovascular-surgical-intervention-in-marfan-syndrome
#13
Rita DelloStritto, Steve Branham, Christina Chemmachel, Jayna Patel, Dayna Skolkin, Salima Gilani, Klever Uleanya
Marfan syndrome is an autosomal dominant connective tissue disorder that affects multiple systems, including the skeletal, ligamentous, oculofacial, pulmonary, abdominal, neurological, and cardiovascular systems. Cardiovascular complications, which involve the aorta and aortic valve, contribute most significantly to patient morbidity and mortality. A literature review was conducted on pathophysiology of the disease and recommendations for early diagnosis and treatment. Diagnosis largely relies on clinical features and a thorough history...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28755814/biomechanical-assessment-of-the-aortic-root-using-novel-force-transducers
#14
T Bechsgaard, J L Hønge, H Nygaard, S L Nielsen, P Johansen
In recent years the use of valve sparing techniques has become more common in selected patients with aortic valve insufficiency. However, limited experimental research has been performed to document the biomechanical effect of these techniques. One experimental platform is to evaluate how the normal physiological aortic root forces are altered or re-established after the surgical intervention. Hence, the aim of this project was to develop new implantable force transducers for a biomechanical description of various aortic root repair techniques...
July 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28747938/computed-tomography-angiography-for-imaging-results-of-neochordal-mitral-valve-repair
#15
Radosław Zwoliński, Anna Marcinkiewicz, Konrad Szymczyk, Jarosław Drożdż, Ryszard Jaszewski, Bogdan Jegier
INTRODUCTION: Degenerative mitral regurgitation is currently the most frequent indication for mitral valve repair. AIM: To visualize and assess the mid-term results of mitral valve repair with neochordae implantation, using computed tomography angiography (CTA) imaging. MATERIAL AND METHODS: The CTA with ECG gating and without modulation was applied in 10 patients to assess the results of a mitral valve sparing procedure. The results of 3 patients are presented...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28740718/papillary-muscle-approximation-in-mitral-valve-repair-for-secondary-mr
#16
REVIEW
Francesco Nappi, Cristiano Spadaccio, Massimo Chello, Christos G Mihos
Ischemic mitral regurgitation (IMR) is a complex disorder occurring after a myocardial infarction and affecting both the mitral valvular and subvalvular apparati. Several abnormalities can be detected in IMR as annular dilatation, leaflet tethering with impaired coaptation and papillary muscle (PM) displacement along a posterior, apical or lateral vectors. Treatments available include, beside myocardial revascularization, mitral-valve repair or chordal-sparing replacement. Repair is normally achieved downsizing the mitral valve annulus with a rigid or semirigid ring...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740678/bicuspid-aortic-root-spared-during-ascending-aorta-surgery-an-update-of-long-term-results
#17
EDITORIAL
Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri, Antonio Pellegrino, Giovanni Ruvolo
BACKGROUND: Bicuspid aortic valve (BAV) aortopathy is well known in literature even if only few data exist regarding isolated supra-coronary aneurysm with normally functioning valve and root. Aim of this study is to clarify the long-term fate of bicuspid aortic root spared at the time of ascending aorta surgery. METHODS: We identified forty-seven patients (mean age, 57±11 y; range, 35-81 y, 31 males) who were treated by means of supracoronary aortic replacement in presence of normally functioning BAV and not significantly enlarged sinues of Valsalva...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28673709/patient-tailored-aortic-root-repair-in-adult-marfanoid-patients-surgical-considerations-and-outcomes
#18
Paul P Urbanski, Atanas Jankulowski, Aleksandra Morka, Vadim Irimie, Xiaochun Zhan, Michael Zacher, Anno Diegeler
OBJECTIVE: The aim of the study was to evaluate the operative and functional results after individual, patient-tailored aortic root repair in marfanoid patients. METHODS: Among 518 patients who underwent operation between 2002 and January 2016, using patient-tailored aortic root repair with isolated sinus replacement, 42 patients fulfilled the original Ghent criteria. None/trivial, mild, moderate, and severe insufficiency grades were present in 5, 16, 10, and 11 patients, respectively...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673110/valve-sparing-root-and-total-arch-replacement-for-cutis-laxa-aortopathy
#19
Anji T Yetman, James Hammel, Jennifer N Sanmann, Lois J Starr
Aortic aneurysms requiring surgery in early childhood are rare. Herein we describe the case of a three-year-old with massive aneurysmal aortic dilation secondary to the rare and often lethal genetic disorder, cutis laxa. Initial thoracic aortic aneurysm gene panel was negative. Parents of the child were not known to be consanguineous, but high-density SNP array revealed several regions of homozygosity. This prompted targeted sequence analysis that identified a novel homozygous missense mutation in the gene for cutis laxa, EFEMP2...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28673107/annuloplasty-for-aortic-regurgitation-in-infantile-takayasu-arteritis-a-case-report
#20
Laura Linnemeier, Richa Sharma, Nayan Srivastava, Mark Turrentine
Aortic regurgitation (AR) is a life-threatening complication of Takayasu arteritis (TA). Takayasu arteritis is a large-vessel vasculitis with a predominance in young adolescent and adult females. Inflammation involves the aorta and its major branches resulting in arterial dilatation, stenosis, aneurysm, occlusion, and thrombosis formation. Pediatric TA cases have been reported to also cause severe complications such as coronary aneurysms, retinopathy, and hypertension due to renovascular stenosis. In this report, we present a rare occurrence of infantile TA with severe AR requiring surgical intervention after failing medical therapy...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
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