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Valve sparing surgery

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https://www.readbyqxmd.com/read/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#1
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
#2
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...
February 23, 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
#3
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...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28259111/evidence-based-surgery-of-aortic-regurgitation-results-of-a-questionnaire-in-german-speaking-countries
#4
Christian Dinges, Johannes Steindl, Wolfgang Hitzl, Tobias Kiesslich, Rainald Seitelberger
Background evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve...
March 4, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#5
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/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#6
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/28007071/valve-sparing-or-valve-reconstruction-options-in-tetralogy-of-fallot-surgery
#7
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/27989095/quadruple-valve-reoperation-after-the-ross-procedure
#8
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/27964981/aortic-root-surgery-with-circulatory-arrest-predictors-of-prolonged-postoperative-hospital-stay
#9
Ourania Preventza, Joseph S Coselli, Andrea Garcia, Shahab Akvan, Sarang Kashyap, Katherine H Simpson, Matt D Price, Kim I de la Cruz, Konstantinos Spiliotopoulos, Lorraine D Cornwell, Faisal G Bakaeen, Shuab Omer, Denton A Cooley
OBJECTIVE: Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery. METHODS: During 2006-2014, 247 of 265 patients (93.2%) with disease extending into the aortic arch survived aortic root operations (206 elective, 41 urgent/emergent) in which hypothermic circulatory arrest with moderate hypothermia was used...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27955909/cardiovascular-operations-for-loeys-dietz-syndrome-intermediate-term-results
#10
Nishant D Patel, Todd Crawford, J Trent Magruder, Diane E Alejo, Narutoshi Hibino, James Black, Harry C Dietz, Luca A Vricella, Duke E Cameron
OBJECTIVES: Early experience with Loeys-Dietz syndrome (LDS) suggested an aggressive aortopathy with high risk of aneurysm dissection and rupture at young ages and at smaller aortic diameters than in other connective tissue disorders. We reviewed our experience with LDS to re-examine our indications and outcomes of surgical management. METHODS: We reviewed all patients with a diagnosis of LDS who underwent cardiovascular surgery at our institution. The primary endpoint was mortality, and secondary endpoints included postoperative complications and need for reintervention...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27942489/is-minimally-invasive-thoracoscopic-surgery-the-new-benchmark-for-treating-mitral-valve-disease
#11
Andrew B Goldstone, Y Joseph Woo
The treatment of mitral valve disease remains dynamic; surgeons and patients must now choose between many different surgical options when addressing mitral regurgitation and mitral stenosis. Notably, advances in imaging and surgical instrumentation allow surgeons to perform less invasive mitral valve surgery that spares the sternum. With favorable long-term data now emerging, we compare the benefits and risks of thoracoscopic mitral valve surgery with that through conventional sternotomy or surgery that is robot-assisted...
November 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27939498/elective-primary-aortic-root-replacement-with-and-without-hemiarch-repair-in-patients-with-no-previous-cardiac-surgery
#12
Ourania Preventza, Joseph S Coselli, Matt D Price, Katherine H Simpson, Ouyang Yafei, Kim de la Cruz, Qianzi Zhang, Susan Green
OBJECTIVE: Excellent outcomes have been established for elective aortic root replacement (ARR). It is less clear whether extending the repair into the proximal aortic arch with hypothermic circulatory arrest increases risk. We examined the early outcomes of elective, primary ARR, with and without hemiarch replacement, in patients without previous cardiac surgery. METHODS: Over a 4-year period, 140 non-redo patients (median age, 54 years) underwent elective, primary ARR for root aneurysms; 119 patients (85%) had hemiarch replacement, and 21 (15%) had only ascending aortic replacement...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27815557/whole-body-perfusion-for-hybrid-aortic-arch-repair-evolution-of-selective-regional-perfusion-with-a-modified-extracorporeal-circuit
#13
Philip Fernandes, Graham Walsh, Stephanie Walsh, Michael O'Neil, Jill Gelinas, Michael W A Chu
BACKGROUND: Patients undergoing hybrid aortic arch reconstruction require careful protection of vital organs. We believe that whole body perfusion with tailored dual circuitry may help to achieve optimal patient outcomes. METHODS: Our circuit has evolved from a secondary circuit utilizing a cardioplegia delivery device for lower body perfusion to a dual-oxygenator circuit. This allows individually controlled regional perfusion with ease of switching from secondary to primary circuit for total body flow...
November 3, 2016: Perfusion
https://www.readbyqxmd.com/read/27765187/aortic-valve-sparing-surgery-yes-but-not-for-every-patient-and-select-the-center-very-carefully
#14
D Craig Miller
No abstract text is available yet for this article.
October 25, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27765186/valve-sparing-root-replacement-compared-with-composite-valve-graft-procedures-in-patients-with-aortic-root-dilation
#15
Maral Ouzounian, Vivek Rao, Cedric Manlhiot, Nachum Abraham, Carolyn David, Christopher M Feindel, Tirone E David
BACKGROUND: Although aortic valve-sparing (AVS) operations are established alternatives to composite valve graft (CVG) procedures for patients with aortic root aneurysms, comparative long-term outcomes are lacking. OBJECTIVES: This study sought to compare the results of patients undergoing AVS procedures with those undergoing CVG operations. METHODS: From 1990 to 2010, a total of 616 patients age <70 years and without aortic stenosis underwent elective aortic root surgery (AVS, n = 253; CVG with a bioprosthesis [bio-CVG], n = 180; CVG with a mechanical prosthesis [m-CVG], n = 183)...
October 25, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27563550/current-surgical-results-of-acute-type-a-aortic-dissection-in-japan
#16
Yutaka Okita
Current surgical results of acute type A aortic dissection in Japan are presented. According to the annual survey by the Japanese Association of Thoracic Surgery, 4,444 patients with acute type A aortic dissection underwent surgical procedures and the overall hospital mortality was 9.1% in 2013. The prevalence of aortic root replacement with a valve sparing technique, total arch replacement (TAR), and frozen stent graft are presented and strategies for thrombosed dissection or organ malperfusion syndrome secondary to acute aortic dissection are discussed...
July 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27556321/initial-surgical-experience-with-aortic-valve-repair-clinical-and-echocardiographic-results
#17
Francisco Diniz Affonso da Costa, Daniele de Fátima Fornazari Colatusso, Ana Claudia Brenner Affonso da Costa, Eduardo Mendel Balbi Filho, Vinicius Nesi Cavicchioli, Sergio Augusto Veiga Lopes, Andrea Dumsch de Aragon Ferreira, Claudinei Collatusso
INTRODUCTION: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. METHODS: From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males...
April 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27436872/valve-sparing-root-replacement-in-children
#18
Jolanda Kluin, David R Koolbergen, Vladimir Sojak, Mark G Hazekamp
OBJECTIVES: In children, words of caution have been raised about valve-sparing procedures especially regarding the valve-remodelling technique. This study reviewed our experience with the valve-sparing reimplantation technique in children. METHODS: All consecutive paediatric (<18 years) patients who underwent valve-sparing root replacement in our centre in the past 12.5 years were retrospectively analysed. RESULTS: Nineteen patients (median age 13...
September 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27373475/-clinical-amalysis-of-left-subclavian-artery-revascularization-by-stented-trunk-fenestration-for-acute-stanford-type-a-aortic-dissection
#19
Y F Tang, L Han, F L Lu, Z G Song, X L Lang, L J Zou, Z Y Xu
OBJECTIVE: To summarize the results and methods of left subclavian artery revascularization by stented trunk fenestration for acute Stanford type A aortic dissection. METHODS: Clinical data of 67 patients (54 male and 13 female, mean age of (50±10) years) underwent surgical treatment of left subclavian artery fenestration for acute Stanford A aortic dissection in Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical College between September 2008 and December 2014 were analyzed retrospectively...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27317087/modified-side-to-side-isoperistaltic-strictureplasty-over-the-ileocaecal-valve-for-the-surgical-treatment-of-terminal-ileal-crohn-s-disease-the-ultimate-bowel-sparing-technique
#20
A de Buck van Overstraeten, A M Wolthuis, A D'Hoore
AIM: The study describes the technique of a modified side-to-side isoperistaltic strictureplasty over the ileocaecal valve. METHOD: The technical details of a modified side-to-side isoperistaltic strictureplasty of the terminal ileum for stricturing Crohn's disease is described including Figs. 1 and 2 and a video illustration (Video S1). RESULTS: Between November 2010 and December 2015, 36 patients underwent a side-to-side isoperistaltic strictureplasty of the (neo-)terminal ileum (men 14/36; median age 35 years [interquartile range (IQR) 26-51 years])...
August 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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