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Valve sparing surgery

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https://www.readbyqxmd.com/read/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#13
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/28508532/aortic-valve-replacement-for-papillary-fibroelastoma
#14
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/28485110/the-role-of-neo-sinus-reconstruction-in-aortic-valve-sparing-surgery
#15
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
#16
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/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/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#18
MULTICENTER STUDY
Elizabeth H Stephens, Jennifer Tingo, Marc Najjar, Betul Yilmaz, Stéphanie Levasseur, Jeffrey D Dayton, Ralph S Mosca, Paul Chai, Jan M Quaegebeur, Emile A Bacha
BACKGROUND: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention. METHODS: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329237/extensive-infective-endocarditis-of-the-aortic-root-and-the-aortic-mitral-continuity-a-mitral-valve-sparing-approach%C3%A2
#19
Anton Tomšic, Adriaan W Schneider, Meindert Palmen, Thomas J van Brakel, Michel I M Versteegh, Robert J M Klautz
OBJECTIVES: Severe cases of infective endocarditis (IE) of the aortic valve can cause aortic root destruction and affect the surrounding structures, including the aortic-mitral continuity, the anterior mitral valve leaflet and the roof of the left atrium. Reconstruction after resection of all infected tissue remains challenging. We describe our surgical approach and the mid-term results. METHODS: Between January 2004 and December 2015, 35 patients underwent surgery for extensive IE of the aortic valve with destruction of the aortic root, the aortic-mitral continuity and the mitral valve...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329094/biological-solutions-to-aortic-root-replacement-valve-sparing-versus-bioprosthetic-conduit%C3%A2
#20
Mario Gaudino, Antonino Di Franco, Lucas B Ohmes, Luca Weltert, Christopher Lau, Ivancarmine Gambardella, Andrea Salica, Monica Munjal, Mohamed Elsayed, Leonard N Girardi, Ruggero De Paulis
OBJECTIVES: Valve-sparing operations and root replacement with a biologic composite conduit are viable options in aortic root aneurysm. This study was conceived to compare the early and mid-term results of these 2 procedures. METHODS: From September 2002 to November 2015, 749 consecutive patients underwent either a valve-sparing operation or a root replacement with a biologic composite conduit at 2 institutions. Propensity score matching was used to compare similar cohorts of patients in the overall population and in the ≤ 55 and ≥ 65-year age groups...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
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