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Valve sparing surgery

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https://www.readbyqxmd.com/read/29127746/-surgical-treatment-of-aortic-root-aneurysm-comparison-of-bentall-procedure-and-david-reimplantation-of-aortic-valve
#1
Jiří Ničovský, Jiří Ondrášek, Jan Černý, Daniela Žáková, Petr Němec
INTRODUCTION: The aortic root aneurysm is associated with a more frequent occurrence of aortic dissection and development of aortic regurgitation. The aim of this study was to compare outcomes of composite graft replacement and valve sparing root replacement in treating aortic root aneurysms. METHODS: From January 2006 to December 2015 a total of 137 patients (mean age 46.3 ± 14.5, range 16-65) underwent elective surgery for aortic root aneurysm without valvular structural defects...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29092110/tavi-for-failed-valve-sparing-operations-in-hospital-and-mid-term-outcome
#2
Francesco Notaristefano, Salvatore Notaristefano, Rocco Sclafani, Matteo R Reccia, Roberto Annunziata, Uberto Da Col, Giuseppe Ambrosio, Claudio Cavallini
BACKGROUND: Although transcatheter aortic valve implantation (TAVI) is a steadily expanding treatment for the pathology of the aortic valve, its role in the replacement of native aortic valves following valve-sparing surgery has not been investigated. METHODS: Among 150 patients who underwent TAVI at the authors' institution, three (2%) had a failed valve-sparing operation. The in-hospital outcome, mid-term mortality, and valvular function of the three patients were evaluated retrospectively...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29050815/right-ventricular-outflow-tract-reintervention-after-primary-tetralogy-of-fallot-repair-in-neonates-and-young-infants
#3
Shyamasundar Balasubramanya, David Zurakowski, Michele Borisuk, Aditya K Kaza, Sitaram M Emani, Pedro J Del Nido, Christopher W Baird
OBJECTIVE: To assess the outcomes following primary tetralogy of Fallot (TOF) repair in neonates and young infants with pulmonary stenosis (PS) and pulmonary atresia and compare differences in reintervention on the right ventricular outflow tract (RVOT) among those undergoing valve sparing repair (VSR), transannular RVOT patch (TAP), and right ventricle-to-pulmonary artery (RV-PA) conduit surgeries. METHODS: Data were collected retrospectively in 101 patients who underwent TOF repair over a 10-year period between January 2005 and September 2015...
September 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049790/sinus-of-valsalva-aneurysms-with-concomitant-aortic-insufficiency-how-should-the-aortic-valve-be-managed
#4
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
#5
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/29019069/pro-con-debate-valve-sparing-aortic-root-surgery-pro-reimplantation
#6
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/28958079/management-of-foetal-circulation-by-switching-to-pulsatile-perfusion-during-cardiovascular-surgery-in-pregnancy
#7
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
#8
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/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#9
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/28759513/importance-of-early-detection-and-cardiovascular-surgical-intervention-in-marfan-syndrome
#10
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/28747938/computed-tomography-angiography-for-imaging-results-of-neochordal-mitral-valve-repair
#11
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
#12
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
#13
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
#14
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
#15
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/28671863/rethinking-the-paradigm-modern-approach-to-proximal-aortic-reconstruction-demonstrates-excellent-outcomes
#16
Jonathan M Hemli, Edward R R DeLaney, Kush R Dholakia, Dror Perk, Nirav C Patel, S Jacob Scheinerman, Derek R Brinster
BACKGROUND: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. METHODS: The majority of our patients were male, mean age 61...
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28646460/a-nationwide-survey-of-aortic-valve-surgery-in-japan-current-status-of-valve-preservation-in-cases-with-aortic-regurgitation
#17
REVIEW
Satoshi Arimura, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Minoru Matsuhama, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya
OBJECTIVE: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery. METHODS: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014. Included in the mailing was a secondary questionnaire that sought further information from institutions reporting aortic valve-sparing surgeries...
August 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28616349/sparing-aortic-valve-techniques
#18
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
#19
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/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#20
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
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