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https://www.readbyqxmd.com/read/29770290/current-surgical-strategies-and-techniques-of-aortic-valve-diseases-in-children
#1
REVIEW
Kun Wang, Huifeng Zhang, Bing Jia
While the long-term outcome of surgical aortic valvotomy (SAV) appears to be better than that of balloon aortic valvuloplasty (BAV) as the primary procedure of aortic valve stenosis, the surgical strategies and techniques of treating aortic valve disease in children in other situations remain controversial. Valve repair should be first considered while replacement is still unavoidable in some cases, and new repair techniques developed by innovative surgeons are gradually becoming adopted. Some complex repair procedures such as cusp extension, leaflet replacement/reconstruction have provided satisfactory outcomes...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#2
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753513/high-incidence-of-late-infective-endocarditis-in-bovine-jugular-vein-valved-conduits
#3
Ziv Beckerman, Luis E De León, Rodrigo Zea-Vera, Carlos M Mery, Charles D Fraser
BACKGROUND: Bovine jugular vein (BJV) grafts (Medtronic, Inc, Minneapolis, Minn) are used to restore right ventricle-to-pulmonary artery continuity. Recent studies have associated these grafts with the development of infective endocarditis. The purpose of this study was to report the incidence of endocarditis in BJV grafts. METHODS: All BJV grafts placed in the right ventricle-to-pulmonary artery position between 2001 and 2017 at our institution were included. Freedom from endocarditis was analyzed using the Kaplan-Meier method and parametric survival regression models...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29707507/bioprosthetics-and-repair-of-complex-aerodigestive-defects
#4
Brooks Udelsman, Douglas J Mathisen, Harald C Ott
Aerodigestive defects involving the trachea, bronchi and esophagus are a result of prolonged intubation, operative complications, congenital defects, trauma, radiation and neoplastic disease. The vast majority of these defects may be repaired primarily. Rarely, due the size of the defect, underlying complexity, or unfavorable patient characteristics, primary repair is not possible. One alternative to primary repair is bioprosthetic repair. Materials such as acellular dermal matrix and aortic homograft have been used in a variety of applications, including closure of tracheal, bronchial and esophageal defects...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29675442/thoracic-endovascular-aortic-repair-for-aortoesophageal-fistula-after-covered-rupture-of-aortic-homograft-a-durable-option
#5
Michal Nozdrzykowski, Jens Garbade, Steffen Leinung, Andrej Schmidt, Friedrich-Wilhelm Mohr, Michael A Borger
A 63-year-old woman underwent replacement of the aortic root, ascending aorta, and partial arch due to Type A aortic dissection. Shortly thereafter, a replacement of the distal aortic arch and descending aorta was performed. Three years later, the patient developed an aortoesophageal fistula (AEF) resulting in re-replacement of the distal aortic arch and proximal descending aorta with a cryopreserved aortic homograft. Six weeks post-discharge, the patient was readmitted due to recurrent AEF. A thoracic endovascular stent graft was implanted to cover the aortic rupture, followed by correction of an esophageal lesion...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29673380/a-standardized-approach-to-treat-complex-aortic-valve-endocarditis-a-case-series
#6
Anna Gomes, Jayant S Jainandunsing, Sander van Assen, Peter Paul van Geel, Bhanu Sinha, Sandro Gelsomino, Daniel M Johnson, Ehsan Natour
BACKGROUND: Surgical treatment of complicated aortic valve endocarditis often is challenging, even for experienced surgeons. We aim at demonstrating a standardized surgical approach by stentless bioprostheses for the treatment of aortic valve endocarditis complicated by paravalvular abscess formation. METHODS: Sixteen patients presenting with aortic valve endocarditis (4 native and 12 prosthetic valves) and paravalvular abscess formation at various localizations and to different extents were treated by a standardized approach using stentless bioprostheses...
April 19, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29659801/long-term-performance-of-homografts-versus-stented-bioprosthetic-valves-in-the-pulmonary-position-in-patients-aged-10-20-years
#7
Douglas Bell, Sudesh Prabhu, Kim S Betts, Yilin Chen, Dorothy Radford, Chris Whight, Cameron Ward, Homayoun Jalali, Prem Venugopal, Nelson Alphonso
OBJECTIVES: We aimed to compare the long-term performance of pulmonary homografts and stented bioprosthetic valves in the pulmonary position in patients aged 10-20 years. METHODS: Between January 1995 and December 2015, 188 patients aged 10-20 years undergoing pulmonary valve replacement were identified retrospectively from hospital databases in both congenital cardiac centres in Brisbane. Valve performance was evaluated using previously described standard criteria...
April 11, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29606322/valve-performance-classification-in-630-subcoronary-ross-patients-over-22-years
#8
Hans-Hinrich Sievers, Ulrich Stierle, Michael Petersen, Stefan Klotz, Doreen Richardt, Michael Diwoky, Efstratios I Charitos
OBJECTIVE: To define the function of the "Ross valves" and its clinical meaning in a practical valve performance classification as part of the outcome analysis. METHODS: From 1994 to 2017, 630 consecutive patients underwent the subcoronary Ross procedure at our institution. The valve performance classification combines hemodynamics, symptoms, and management criteria. Median follow-up was 12.5 years (maximum 22.3 years, 7404 patient-years, 99.4% completeness)...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29571631/vitrification-of-aortic-valve-homografts-suppresses-nlrp3-inflammasome-activation-and-alleviates-the-inflammatory-response-after-transplantation
#9
Yulong Sui, Bin Wang, Qing Fan, Wenjie Zhu, Jixian Wang, Qing Chang
No abstract text is available yet for this article.
March 20, 2018: Cryobiology
https://www.readbyqxmd.com/read/29564333/surgery-for-young-adults-with-aortic-valve-disease-not-amenable-to-repair
#10
Mustafa Zakkar, Vito Domanico Bruno, Alexandru Ciprian Visan, Stephanie Curtis, Gianni Angelini, Emmanuel Lansac, Serban Stoica
Aortic valve replacement is the gold standard for the management of patients with severe aortic stenosis or mixed pathology that is not amenable to repair according to currently available guidelines. Such a simplified approach may be suitable for many patients, but it is far from ideal for young adults considering emerging evidence demonstrating that conventional valve replacement in this cohort of patients is associated with inferior long-term survival when compared to the general population. Moreover; the utilisation of mechanical and bioprosthetic valves can significantly impact on quality and is linked to increased rates of morbidities...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29518535/successful-use-of-aortic-homograft-for-residual-tracheal-stenosis-following-slide-tracheoplasty
#11
T K Susheel Kumar, Camille Immanuel, Jerome Thompson, Samir Shah, Christopher Knott-Craig
No abstract text is available yet for this article.
March 5, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29481612/accelerated-acute-severe-antibody-mediated-graft-failure-related-to-a-ross-procedure-17-years-earlier
#12
Martin Andreas, Kathrin Freystaetter, Martin H Bernardi, Andreas Zuckermann
A 31-year-old male patient underwent a heart transplantation due to dilated cardiomyopathy. He experienced accelerated acute antibody-mediated rejection despite being negative for human leukocyte antigen antibodies (0% panel-reactive antibodies prior to surgery). Further assessment revealed a common antigen between a homograft implanted 17 years earlier during the Ross procedure and the heart donor. The homograft likely induced specific antibody formation. Interestingly, panel-reactive antibody levels measured 7 years prior to transplantation were 7%...
February 21, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29457616/successful-pulmonary-homograft-re-implantation-after-previous-surgical-and-percutaneous-interventions
#13
Mateusz Kuć, Szymon Kocańda, Marcin Demkow, Jacek Różański, Mariusz Kuśmierczyk
No abstract text is available yet for this article.
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29455964/polytetrafluoroethylene-conduits-versus-homografts-for-right-ventricular-outflow-tract-reconstruction-in-infants-and-young-children-an-institutional-experience
#14
Christopher W Mercer, Shawn C West, Mahesh S Sharma, Masahiro Yoshida, Victor O Morell
OBJECTIVE: Our institution uses a valved polytetrafluoroethylene conduit as an alternative to homografts. The objective of this study was to investigate the performance of bicuspid valved polytetrafluoroethylene conduits used for right ventricular outflow tract reconstruction in children aged less than 2 years and to evaluate risk factors for earlier conduit explant. METHODS: We performed an Institutional Review Board-approved retrospective chart review of all patients aged less than 2 years who underwent surgical right ventricular outflow tract reconstruction with a bicuspid valved polytetrafluoroethylene conduit or homograft conduit from July 2004 to December 2014...
May 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29452118/long-term-outcome-of-interrupted-arch-repair-with-direct-anastomosis-and-homograft-augmentation-patch
#15
Mohammed Mohsin Uzzaman, Natasha E Khan, Ben Davies, John Stickley, Timothy J Jones, William J Brawn, David J Barron
BACKGROUND: We analysed outcomes of IAA repair using a standardised technique in order to interpret the role of the arch repair on late outcomes in this complex and heterogeneous group. METHODS: Single institution study from 1988-2015. 120 cases of IAA were divided into four groups: IAA with VSD (iVSD, n=38), IAA with Norwood/DKS (iNor, n=41), IAA with Truncus (iTruncus, n=24) and miscellaneous group (iMisc, n=17). Arch repair performed using a standard technique of direct anastomosis with homograft patch augmentation...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29440843/large-pseudoaneurysm-following-right-ventricle-to-pulmonary-artery-homograft-placement-in-an-infant
#16
Rini Sahewalla, Robert D Ross, Ralph E Delius, Ryan Halas, Premchand Anne
Pseudoaneurysm (PSA) is a known but rare complication of the right ventricle to pulmonary artery (RV-PA) conduits. The patient's clinical presentation can be variable ranging from asymptomatic to potential rupture. We describe an unusual case of a massive PSA in an infant who underwent RV-PA pulmonary homograft placement after relief of right ventricular outflow tract obstruction.
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29430429/extracardiac-conduit-fontan-operation-with-reduction-aortoplasty-for-left-pulmonary-artery-compression-after-a-norwood-procedure-in-a-patient-with-double-inlet-left-ventricle
#17
Jae Won Song, Woong Han Kim, Jae Gun Kwak, Ji Young Park
Patients with double-inlet left ventricle usually have a small ascending aorta. In the Norwood procedure, which involves a staged operation, a neoaorta is constructed with a homograft, and the pulmonary artery plays a role in the systemic circulation. Dilatation or aneurysmal changes can occur over time due to the exposure of the neoaorta to systemic pressure, which may induce adverse effects on adjacent structures. We report a rare case of surgical repair for neoaortic root dilataiton with aortic regurgitation, compressing the left pulmohary artery, in a patient who underwent the Norwood procedure...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29428623/modified-repair-of-type-i-and-ii-truncus-arteriosus-limits-early-right-ventricular-outflow-tract-reoperation
#18
Clauden Louis, Michael F Swartz, Bartholomew V Simon, Jill M Cholette, Nader Atallah-Yunes, Hongyue Wang, Francisco Gensini, George M Alfieris
Repair of truncus arteriosus often requires early right ventricular outflow tract (RVOT) reoperation. Using a modified repair, the branch pulmonary arteries are left in situ, which may avoid earlier RVOT reoperation. We hypothesized that our modified repair for type I and II truncus arteriosus would extend the time to RVOT reoperation. Infants with truncus arteriosus were divided into 2 groups: (1) traditional technique where the branch pulmonary arteries are excised from the truncal root, or (2) modified repair where the branch pulmonary arteries are left in situ and septated from the truncal root...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29421428/cryopreserved-homografts-in-infected-infrainguinal-fields-are-associated-with-frequent-reinterventions-and-poor-amputation-free-survival
#19
S Keisin Wang, Ashley R Gutwein, Natalie A Drucker, Michael P Murphy, Andres Fajardo, Michael C Dalsing, Raghu L Motaganahalli, Gary W Lemmon
BACKGROUND: Single-length saphenous vein continues to be the conduit of choice in infected-field critical limb ischemia. However, half of these individuals have inadequate vein secondary to previous use or chronic venous disease. We reviewed our outcomes of infected-field infrainguinal bypasses performed with cryopreserved homografts (CHs), a widely accepted alternative to autogenous vein in this setting. METHODS: This is a retrospective, institutional descriptive analysis of infected-field infrainguinal revascularizations between 2012 and 2015...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29395212/transcatheter-versus-surgical-valve-replacement-for-a-failed-pulmonary-homograft-in-the-ross-population
#20
Khadija Alassas, Dania Mohty, Marie Annick Clavel, Aysha Husain, Talal Hijji, Mansour Aljoufan, Zohair Alhalees, Bahaa M Fadel
BACKGROUND: Patients who undergo the Ross procedure are at increased risk of pulmonary valve (PV) homograft dysfunction. For those who require reintervention on the homograft, transcatheter PV replacement (tPVR) provides a less invasive therapeutic option than surgical PVR (sPVR). We examined the outcomes following tPVR versus sPVR in a cohort of patients who underwent the Ross procedure. METHODS: We performed a retrospective analysis of Ross patients age ≥14 years who underwent tPVR (n = 47) or sPVR (n = 41) at our institution...
April 2018: Journal of Thoracic and Cardiovascular Surgery
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