scholarly journals Perceval sutureless aortic valve replacement after ascending aortic replacement

2021 ◽  
Vol 9 (12) ◽  
Author(s):  
Shin Yajima ◽  
Ayaka Satoh ◽  
Naosumi Sekiya ◽  
Sachiko Yamazaki ◽  
Hisashi Uemura ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Replacement ◽  
Ascending Aortic Replacement

scholarly journals Does the 45 mm Size Cutoff for Ascending Aortic Replacement Predict Better Early Outcomes in Bicuspid Aortic Valve?

2021 ◽  
Author(s):  
Yi-Jia Li ◽  
Wei-Guo Ma ◽  
Yue Qi ◽  
Jun-Ming Zhu ◽  
Ya Yang ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Adverse Events ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Aortic Replacement ◽  
Ascending Aortic Replacement ◽  
Size Criterion

Abstract Background The aim of this study is to test if the newly proposed 45 mm size criterion for ascending aortic replacement (AAR) in bicuspid aortic valve (BAV) patients undergoing aortic valve replacement (AVR) is predictive of improved early outcomes. Methods Data of 306 BAV patients with an aortic diameter of ≥45 mm undergoing AVR alone or with AAR were retrospectively analyzed. Patients were divided into groups of AVR + AAR (n = 220) and AVR only (n = 86) based on if surgery was performed according to the 45 mm criterion. End point was early adverse events, including 30-day and in-hospital mortality, cardiac events, acute renal failure, stroke, and reoperation for bleeding. Cox regression was used to assess if conformance to 45 mm criterion could predict fewer early adverse events. Results AVR + AAR group had significantly higher postoperative left ventricular ejection fraction (LVEF) (0.59 ± 0.09 vs. 0.55 ± 0.11, p = 0.006) and longer cardiopulmonary bypass (CPB) time (128 vs. 111 minutes, p = 0.002). Early adverse events occurred in 45 patients (14.7%), which was more prevalent in the AVR-only group (22.1% vs. 11.8%, p = 0.020). Conformance to the 45 mm criterion predicted lower rate of early adverse events (hazard ratio [HR]: 0.53, 95% confidence interval [CI]: 0.28–0.98, p = 0.042). After adjustment for gender, age, AAo diameter, sinuses of Valsalva diameter, preoperative LVEF, Sievers subtypes, BAV valvulopathy, and CPB and cross-clamp times, conformance to the 45 mm size criterion still predicted lower incidence of early adverse events (HR: 0.37, 95% CI: 0.15–0.90, p = 0.028). Conclusions This study shows that conformance to 45 mm size cutoff for preemptive AAR during aortic valve replacement in patients with BAV was not associated with increased risk for adverse events and may improve early surgical outcomes.

scholarly journals Mid-term durability of polytetrafluoroethylene patches in unicuspid aortic valve repair

2020 ◽  
Vol 31 (4) ◽  
pp. 555-558
Author(s):  
Irem Karliova ◽  
Tristan Ehrlich ◽  
Shunsuke Matsushima ◽  
Sebastian Ewen ◽  
Hans-Joachim Schäfers
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Severe Aortic Regurgitation ◽  
Aortic Replacement ◽  
Primary Indication ◽  
Ascending Aortic Replacement

Abstract OBJECTIVES Unicuspid aortic valve (UAV) morphology is a cause for aortic valve dysfunction in childhood or adolescence. Repair requires the use of patch material, and polytetrafluoroethylene (PTFE) has been proposed for this purpose because of lack of calcification. We reviewed our mid-term experience with PTFE for the repair of UAV to analyse the durability of this technique. METHODS Out of 21 patients with an UAV undergoing aortic valve repair for severe aortic regurgitation between 2014 and 2016, 11 patients (52%) were treated using PTFE patch material. Aortic regurgitation was present in all patients, the primary indication for surgery was regurgitation in 8, stenosis in 2 and aneurysm in 1. Symmetric bicuspidization of the UAV was performed in all. One patient required additional root remodelling for root dilatation, and another 3 tubular ascending aortic replacement. RESULTS No patient died in hospital or during follow-up. Seven patients (63.6%) required reoperation for progressive AR. Freedom from reoperation was 58% at 1 and 35% at 5 years postoperatively. At reoperation the PTFE patches were found dehisced from aortic wall and/or native cusp tissue. In 3 patients re-repair was performed; a stable result was achieved in 1. Two patients underwent valve replacement 3 months and 1 year postoperatively. The other 4 patients underwent valve replacement. CONCLUSIONS The repair of UAVs using PTFE patch is associated with poor durability, a more durable patch with better healing characteristics material is needed.

scholarly journals Immediate Improvement in Severe Mitral Regurgitation After Aortic Valve Replacement for Severe Aortic Insufficiency

Aorta ◽  
2016 ◽  
Vol 04 (03) ◽  
pp. 91-94 ◽  
Author(s):  
Ahmad Zeeshan ◽  
Mojun Zhu ◽  
John Elefteriades
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Insufficiency ◽  
Functional Mitral Regurgitation ◽  
Severe Mitral Regurgitation ◽  
Severe Aortic Regurgitation ◽  
Aortic Replacement

AbstractA 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve.

Minimal-Access Aortic Valve Replacement with Concomitant Aortic Procedure: A 9-Year Experience

2012 ◽  
Vol 7 (5) ◽  
pp. 368-371 ◽  
Author(s):  
Tsuyoshi Kaneko ◽  
Gregory S. Couper ◽  
Wernard A.A. Borstlap ◽  
Foeke J.H. Nauta ◽  
Laurens Wollersheim ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Length Of Stay ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Circulatory Arrest ◽  
Aortic Surgery ◽  
Morbidity Rate ◽  
Minimal Access ◽  
True Aneurysm ◽  
Aortic Replacement

Objective Minimal-access approaches through upper hemisternotomy is an established technique for aortic valve replacement (AVR) and aortic surgery in our institution. We assessed the outcome of undergoing AVR with concomitant aortic surgery through upper hemisternotomy. Methods We retrospectively reviewed 109 patients from January 2002 to May 2011 who had AVR with concomitant aortic surgery through upper hemisternotomy. Aortic valve replacement with supra-coronary ascending aortic replacement was performed in 65 patients; AVR with ascending and proximal arch replacement, in 8 patients; AVR with aortoplasty, in 11 patients; Bentall procedure, in 8 patients; and AVR with root enlargement, in 13 patients. In-hospital outcomes and 1- and 5-year survival were examined. Results The mean age was 58.5 years (range, 23–89 years); 41.3% of patients had bicuspid aortic valve (n = 45). Of the patients, 82.6% had true aneurysm (n = 90), 2.8% had calcified aorta (n = 3), 8.3% had small annulus (n = 9), and 3.7% had calcified annulus (n = 4). There were 6 (5.5%) reoperations and 15 (13.8%) urgent cases. Mean perfusion time was 152 ± 61 minutes, and cross-clamp time was 108 ± 47 minutes. Nine cases were performed with deep hypothermic circulatory arrest (8.3%). Operative mortality was 2.8% (n = 3). There were 4 (3.7%) cases with reoperation for bleeding, 2 (1.8%) myocardial infarctions, and 2 (1.8%) new-onset renal failure. Mean length of stay was 7.1 ± 5.6 days. Kaplan-Meier analysis showed that 1-year postoperative survival was 96.2% and 5-year survival was 92.4%. Conclusions An upper hemisternotomy approach is safe and feasible for AVR and concomitant aortic surgery with good early and midterm outcomes. This approach is also associated with low morbidity rate and short length of stay.

scholarly journals Demographic Characteristics, BAV Sievers Types, and Interactions Between BAV-Associated Valvulopathy and Aortopathy Differently Affect BAV Comorbidities and Outcomes of Aortic Valve Replacement

2020 ◽  
Author(s):  
Yijia Li ◽  
Qiong Zhao ◽  
Yue Qi ◽  
Yichen Qu ◽  
Akshay Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Serum Triglyceride ◽  
Left Ventricular ◽  
Demographic Characteristics ◽  
Baseline Characteristic ◽  
Factors Associated ◽  
Aortic Replacement

Background: Bicuspid aortic valve (BAV) is a common congenital disorder. The relationship between demographic and clinical characteristics, BAV Sievers types, BAV associated valvulopathy and/or aortopathy and outcomes of aortic valve replacement (AVR) are interwoven and complicate and have not been fully elucidated. We sought to find these interactions in a large cohort of BAV patients. Methods: We retrospectively reviewed the data of 992 BAV patients and collected the complete demographic and clinical data (baseline characteristic, BAV Sievers types, BAV valvulopathy and aortopathy, and pre-, intra- and postoperative data) to comprehensively analyze these relationships. Results: In 992 BAV patients, sex differences could be found in demography (body surface area [BSA], age and serum triglyceride), comorbidities, cardiac performance (left ventricular dimension and ejection fraction,), valvulopathy and aortopathy. Sievers types had the same distribution among male and female patients, and had an impact on the incidence of valvulopathy and aortopathy. In the entire cohort, the factors associated with valvulopathy included age, sex, BSA, systolic blood pressure (SBP) and aortopathy, while factors associated with aortopathy were age, sex, BSA and valvulopathy. Aortopathy and valvulopathy promoted the occurrence of each other. Similar risk factors for valvulopathy and aortopathy in male patients were found. For 658 BAV patients underwent AVR, the preoperative demographic characteristics were similar to the whole cohort. More males were required to have simultaneous ascending aortic replacement (AAR). For postoperative early adverse events (EAE) and total ICU hours > 24 hours, the only predict factors were age and aortic cross clamp (ACC) time, while LVEF changes (including postoperative LVEF <50%, LVEF increase or decrease more or less than 5% or 10%) were related to sex, SBP, preoperative LVEF, valvulopathy and aortopathy, AAR, ACC time. Postoperative length of stay > 7 days could be affected by SBP, AAR, aortic stenosis and ACC time. Conclusion: Our study revealed comprehensive relationships between demographic characteristics, BAV Sievers types, valvulopathy and aortopathy, and the possible risk factors for adverse outcomes after AVR in BAV patients. Sex, SBP, age, Sievers types, subtypes and interactions between aortopathy and valvulopathy differently impact on aortopathy, valvulopathy and the short outcomes of AVR.

scholarly journals A ministernotomia szerepe az aortabillentyű-sebészetben

2016 ◽  
Vol 157 (23) ◽  
pp. 901-904
Author(s):  
Gábor Bari ◽  
László Csepregi ◽  
Miklós Bitay ◽  
Gábor Bogáts
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Surgery ◽  
Valve Surgery ◽  
Minimal Access ◽  
Aortic Valve Surgery ◽  
Aortic Replacement ◽  
The University ◽  
Special Instrumentation

Introduction: Minimal access aortic valve replacement plays a significant role in modern cardiac surgery. The technical evolution of aortic bioprostheses, particularly sutureless valves, leads to simplify minimal access aortic valve surgery and it allows easier implantation in a narrow work field with the need of less manipulation. Aim: The aim of this study is to summarize the historical and technical aspects of minimal access aortic valve replacement, especially concentrating on sutureless valves, and to present data of own patients of the authors. Method: Pre- and post-operative data of 13 minimal access aortic replacement cases who were operated at the Deparment of Cardiac Sugery at the University of Szeged are summarized. Results and conclusions: As compared to full sternotomy, minimal access aortic surgery is safe, and it does not require special instrumentation. It is technically more demanding but it can be learned quickly, and the overall pre- and post-operative results are not worse with the benefit of less pain and superior cosmetics. Orv. Hetil., 2016, 157(23), 901–904.

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