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Valve sparing surgery

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https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27212978/valve-sparing-surgery-in-an-adult-patient-with-dextrocardia-and-annuloaortic-ectasia
#17
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
https://www.readbyqxmd.com/read/27174548/management-of-early-graft-infections-in-the-ascending-aorta-and-aortic-arch-a-comparison-between-graft-replacement-and-graft-preservation-techniques
#18
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...
October 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27151757/value-of-multidimensional-modeling-in-planning-surgery-for-a-dissecting-ventricular-septal-hematoma-following-aortic-valve-sparing-root-reimplantation
#19
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
https://www.readbyqxmd.com/read/27040015/single-centre-experience-in-surgery-of-acute-aortic-type-a-dissection-and-true-aortic-arch-aneurysm
#20
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
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