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Valve sparing surgery

Nazan Puluca, Melchior Burri, Julie Cleuziou, Markus Krane, Rüdiger Lange
OBJECTIVES: Most patients (75%) with Marfan syndrome present with aortic root dilatation that may require surgical intervention. However, associated cardiovascular disorders are not limited to the aortic root. These patients frequently require consecutive operations on the remaining thoracic aorta or the heart valves. Our intent was to characterize the spectrum of such procedures. METHODS: Data from all patients with Marfan syndrome undergoing aortic root surgery at our centre between 1988 and 2016 were analysed retrospectively...
February 28, 2018: European Journal of Cardio-thoracic Surgery
Kazuhiro Yamazaki, Kenji Minatoya, Ryoma Ueda, Masato Takehara, Kazuhisa Sakamoto, Yujiro Ide, Hideo Kanemitsu, Koji Ueyama, Tadashi Ikeda
Valve-sparing root replacement is increasingly used to overcome drawbacks associated with valvular prostheses. In our institution, 7 patients underwent valve-sparing root replacement from August 2016 to July 2017. The mean age was 45 years (range, 14~69 years). Three patients had Marfan syndrome and 1 had Loeys-Dietz syndrome with acute aortic dissection. All patients underwent surgery with reimplantation technique using a Valsalva graft. Two patients required repair of aortic valve leaflet prolapse. All patients had an excellent clinical course, with mild or no aortic regurgitation and a decrease in end-diastolic volume on echocardiography...
January 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
A M CHernyavskiy, D V Doronin, D S Khvan, S A Alsov, D A Sirota, M M Lyashchenko, V I Safina
No abstract text is available yet for this article.
September 2017: Kardiologiia
Parag K Shah, Vishma Prabhu, Venkatapathy Narendran
AIM: To report our initial experience with lens-sparing vitrectomy for stage 4 retinopathy of prematurity using the 27-gauge (G) system. METHODS: This retrospective case series involved nine eyes of five babies with active stage 4 ROP, who underwent 27-G lens-sparing vitrectomy. Surgery was done using 27-G valved cannulas and sclerotomies were made 1.5 mm from the limbus. Bilateral sequential vitrectomy was done in eight eyes. RESULTS: At one-year follow-up, anatomical outcome was favourable in all nine (100%) eyes...
February 8, 2018: World Journal of Clinical Pediatrics
Nicola Galea, Filippo Piatti, Francesco Sturla, Jonathan W Weinsaft, Christopher Lau, Ilaria Chirichilli, Iacopo Carbone, Emiliano Votta, Carlo Catalano, Ruggero De Paulis, Leonard N Girardi, Alberto Redaelli, Mario Gaudino
OBJECTIVES: This study was undertaken to evaluate the flow dynamics in the aortic root after valve-sparing root replacement with and without neosinuses of Valsalva reconstruction, by exploiting the capability of 4D Flow imaging to measure in vivo blood velocity fields and 3D geometric flow patterns. METHODS: Ten patients who underwent valve-sparing root replacement utilizing grafts with neosinuses or straight tube grafts (5 cases each) were evaluated by 4D Flow imaging at a mean of 46...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Takashi Kunihara
January 8, 2018: General Thoracic and Cardiovascular Surgery
Simrenjeet Sandhu, Michael W Dorey
This case study reports the successful implantation of the Xen ab interno gel stent in a 44-year-old male with refractory chronic open angle glaucoma. The patient had multiple unsuccessful filtration surgeries including a trabeculectomy and two Ahmed glaucoma valves placed superotemporally and inferonasally OD. The patients intraocular pressure was reduced from 29▒mm Hg preoperatively to 17▒mm Hg 1 year after surgery, without any ocular complications. The Xen gel stent may be considered as a possible intervention to lower IOP in patients with refractory glaucoma, despite previous filtration surgeries if the superonasal conjunctiva is spared and healthy...
January 4, 2018: Journal of Glaucoma
Abdel-Kémal Bori Bata, Nicolas D'Ostrevy, Bruno Pereira, Etienne Geoffroy, Nicolas Dauphin, Vedat Eljezi, Kasra Azarnoush, Lucie Ulman, Lionel Camilleri
Background: This study evaluated the midterm outcomes, the valve related events and quality of life of patients treated by valve-sparing aortic root replacement (VSRR). Methods: From January 2003 to December 2014, 88 consecutive patients diagnosed with an aortic root aneurysm or ascending aortic aneurysms underwent VSRR surgery. The mean age was 55±14 (range 19-77) years. A total of 84% of the patients were male; 89% were in New York Heart Association functional class I or II, 55% had aortic regurgitation (AR) grade III or IV...
December 2017: Cardiovascular Diagnosis and Therapy
Sophie C Hofferberth, Meena Nathan, Gerald R Marx, Minmin Lu, Lynn A Sleeper, Audrey C Marshall, Christopher W Baird, John E Mayer, Pedro J Del Nido, Sitaram M Emani
OBJECTIVES: The significant morbidity of long-term pulmonary regurgitation (PR) has driven the development of pulmonary valve (PV) sparing repair strategies in patients with tetralogy of Fallot (ToF). We assessed mid-term PV function in patients who underwent primary ToF repair with valve-sparing intraoperative balloon dilation (IBD) technique. METHODS: We evaluated 162 consecutive patients with ToF and pulmonary stenosis (ToF-PS) who underwent valve-sparing repair with IBD under 1 year of age...
March 2018: Journal of Thoracic and Cardiovascular Surgery
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
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
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
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
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.
December 20, 2017: Annals of Thoracic and Cardiovascular Surgery
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
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
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
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
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
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
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