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Valve sparing surgery

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
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
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
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]
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
Rahmi Zeybek, Ahmet Bacaksiz, Rasul Sharifov, Emrah Sevgili, Yasin Ay
We report the case of a patient with situs inversus totalis, annuloaortic ectasia complicated by aortic insufficiency and mitral regurgitation which induced congestive heart failure. Both valvular lesions were repaired physiologically using aortic root sparing Yacoub 'remodeling' technique and mitral ring annuloplasty. Valve sparing techniques can be used effectively even in patients with complicated clinical scenarios (like dextrocardia and annuloaortic ectasia) to avoid the potential risks related to prosthetic valve implantation and lifelong anticoagulation therapy...
March 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Julia Umminger, Heike Krueger, Erik Beckmann, Tim Kaufeld, Felix Fleissner, Axel Haverich, Malakh Shrestha, Andreas Martens
OBJECTIVES: Treatment of infected thoracic aortic grafts is associated with considerable morbidity and mortality. The replacement of an infected graft is an effective strategy, yet a complex surgical endeavour, especially if the aortic root or aortic arch is involved. In situ graft-sparing surgical therapy with continuous mediastinal irrigation after surgical debridement might offer an alternative in the management of early graft infections in the thoracic aorta. METHODS: Between 1996 and August 2015, 25 patients were treated in our institution for early graft infection after thoracic aortic surgery via sternotomy...
May 12, 2016: European Journal of Cardio-thoracic Surgery
Abdullrazak Hossien, Sandro Gelsomino, Bahremsjah Mochtar, Peyman Sardari Nia, Suzanne Kats, Jos Maessen
We report a technique of multidimensional modeling (MDM) used to assist in the planning of a repair of a dissecting ventricular septal hematoma (DVSH) following a David procedure. doi: 10.1111/jocs.12757 (J Card Surg 2016;31:390-393).
June 2016: Journal of Cardiac Surgery
Tomasz Hirnle, Adrian Stankiewicz, Krzysztof Matlak, Marek Frank, Robert Trzciński, Anna Lejko, Arkadiusz Niedźwiecki, Maciej Mitrosz, Iwona Dmitruk, Marta Milewska-Buzun, Grzegorz Hirnle
BACKGROUND: Surgery of the aortic arch is challenging. AIM: To assess the results of aortic arch surgery. METHODS: Analysis of 172 patients operated on arch dissection (emergency group: 97 patients) or aneurysm (elective group: 75 patients) between 2007 and 2014. Arch surgery was defined as a procedure requiring circumferential anastomosis at the level of the aortic arch or the descending aorta with the use of techniques of brain protection (deep hypothermic circulatory arrest [DHCA] or selective antegrade cerebral perfusion [SACP]) and/or debranching of at least one supra-aortic vessel...
2016: Kardiologia Polska
Pavel Zacek, T Holubec, M Vobornik, J Dominik, J Takkenberg, J Harrer, J Vojacek
BACKGROUND: In patients after aortic valve surgery, the quality of life is hypothesized to be influenced by the type of the valve procedure. A cross-sectional study on the postoperative quality of life was carried out in patients after aortic valve-sparing surgery (with regards to the age of the patient), Ross procedure and mechanical aortic valve replacement. METHODS: Quality of life was studied in 139 patients after aortic valve surgery divided into four study groups (Y - aortic valve-sparing procedure at the age below 50 years, mean age 36...
2016: BMC Cardiovascular Disorders
Marco Russo, Fabio Bertoldo, Paolo Nardi, Antonella D'Annolfo, Guglielmo Saitto, Antonio Pellegrino, Luigi Chiariello
BACKGROUND AND AIM OF THE STUDY: Bicuspid aortic valve (BAV), though normally functioning, is frequently associated with dilatation of the aortic root and ascending aorta. Optimal surgical treatment remains controversial. The study aim was to evaluate the fate of the normally functioning spared BAV at long-term follow up. METHODS: Forty patients (26 males, 14 females; mean age 59 +/- 11 years; range: 38-81 years) who underwent aortic surgery for proximal aortic disease between 1996 and 2011, with spared BAV at surgery, were included in the study...
September 2015: Journal of Heart Valve Disease
Paul P Urbanski, Aristidis Lenos, Vadim Irimie, Petros Bougioukakis, Michael Zacher, Anno Diegeler
OBJECTIVES: The aim of the study was to evaluate operative and long-term results after surgery of acute aortic dissection involving the root, in which the proximal repair consisted of curative resection of all dissected aortic sinuses and was performed using either valve-sparing root repair or complete root replacement with a valve conduit. METHODS: Between August 2002 and March 2013, 162 consecutive patients (mean age 63 ± 14 years) underwent surgery for acute type A aortic dissection...
May 2016: Interactive Cardiovascular and Thoracic Surgery
Bobby Yanagawa, David Latter, Subodh Verma
PURPOSE OF REVIEW: In the past year, there has been progress on several fronts in the field of mitral valve surgery and intervention. Here, we review key publications regarding the surgical and transcatheter management of mitral valve disease. RECENT FINDINGS: This past year heralded the publication of the 2014 American Heart Association (AHA)/American College of Cardiology (ACC) Guidelines for the Management of Patients With Valvular Heart Disease. Regarding degenerative mitral regurgitation, low risk of operative mortality and data demonstrating clinical benefit for early surgery are prompting renewed calls for early intervention before guideline-based triggers...
March 2016: Current Opinion in Cardiology
Tom Treasure, J J M Takkenberg, John Pepper
Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR can be performed irrespective of aortic dimensions and a mechanical replacement valve is a secure and near certain means of correcting aortic valve regurgitation but has thromboembolic and bleeding risks...
February 2016: Postgraduate Medical Journal
Vikrant Dhurandhar, Roneil Parikh, Akshat Saxena, Michael P Vallely, Michael K Wilson, Deborah Ann Black, Lavinia Tran, Christopher Reid, Paul G Bannon
BACKGROUND: Valve sparing aortic root reconstruction (VSARR) has become an alternative to traditional aortic root replacement with a valved conduit. There have been various modifications but the two broad types are aortic root reimplantation and the aortic root remodelling procedure. We present the early and late outcomes following valve sparing aortic root reconstruction surgery in Australia. METHODS: We reviewed the ANZSCTS database for patients undergoing these procedures...
May 2016: Heart, Lung & Circulation
Lauren Basmadjian, Arsène J Basmadjian, Louis-Mathieu Stevens, François-Pierre Mongeon, Raymond Cartier, Nancy Poirier, Ismail El Hamamsy
OBJECTIVES: Dilatation of the aortic annulus is a cause of recurrent aortic regurgitation following the Ross or Yacoub procedures. Use of an extra-aortic annuloplasty ring is a potentially useful adjunct procedure. The aim of this study was to analyze the early effectiveness and mid-term stability of this surgical approach. METHODS: From 2011 to 2015, 50 patients (mean age, 43 ± 14 years) underwent adjunct extra-aortic annuloplasty ring implantation (n = 39 Dacron rings and n = 11 ExAo rings [CORONEO Inc, Montreal, Canada])...
May 2016: Journal of Thoracic and Cardiovascular Surgery
Giedrius Baliulis, Jussi O Ropponen, Tony P Salmon, Markku O Kaarne
OBJECTIVES: To review our experience with valve-sparing aortic root replacement (VSARR) in adult patients after the previous surgery for congenital heart disease. METHODS: From August 2008 to February 2014, 11 patients (mean age: 30.5 ± 7.7 years), previously operated for various congenital cardiac defects, mostly conotruncal lesions, underwent VSARR for progressive aortic root dilatation. Five patients had also developed moderate, and 1 patient severe aortic valve (AoV) insufficiency...
July 2016: European Journal of Cardio-thoracic Surgery
Fabian A Kari, Kai-Nicolas Doll, Wolfgang Hemmer, Markus Liebrich, Hans-Hinrich Sievers, Doreen Richardt, Hermann Reichenspurner, Christian Detter, Matthias Siepe, Martin Czerny, Friedhelm Beyersdorf
OBJECTIVES: The aim of this study was to characterize mortality and aortic valve replacement after valve-sparing aortic root replacement (V-SARR) in a multicentre cohort. METHODS: Between 1994 and 2014, 1015 patients had V-SARR with (n = 288, 28%) or without cusp/commissure repair (n = 727, 72%) at the centres of Lübeck (n = 343, 34%), Stuttgart (n = 346, 34%), Hamburg (n = 109, 11%) and Freiburg (n = 217, 21%), Germany. Comparative survival of an age- and gender-matched general population was calculated...
April 2016: Interactive Cardiovascular and Thoracic Surgery
Charline Pujos, Marie-Catherine Morgant, Ghislain Malapert, Olivier Bouchot
BACKGROUND: Sinus of Valsalva aneurysm is an uncommon anomaly of the aorta. It occurs most frequently in the right sinus of Valsalva. Complications depend on its size and location. Situs inversus totalis is a rare condition wherein organs are reversed from their normal positions (mirror image). CASE PRESENTATION: We report the case of a 69-year-old man who presented situs inversus totalis known since his childhood and a sinus of Valsalva aneurysm in the right coronary sinus discovered by echocardiography following a history of infection...
2015: Journal of Cardiothoracic Surgery
Igor Gosev, Maroun Yammine, Marzia Leacche, Siobhan McGurk, Vladimir Ivkovic, Michael N D'Ambra, Lawrence H Cohn
BACKGROUND: Posterior mitral valve leaflet prolapse due to degenerative mitral valve disease has been treated with tissue sparing repair techniques since 2002. The simplified foldoplasty technique effectively lowers the height of the redundant posterior leaflet and creates an optimal coaptation line for the anterior leaflet that results in excellent long term durability, freedom from reoperation, and return of functional status. METHODS: Patient demographics and in-hospital outcome data were extracted from electronic medical records of 229 patients, aged 60...
September 2015: Annals of Cardiothoracic Surgery
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