Surgical Treatment of Aortic Valve Regurgitation Secondary to Ascending Aorta Aneurysm: Is Adjunctive Subcommissural Annuloplasty Necessary?

2013 ◽  
Vol 95 (2) ◽  
pp. 586-592 ◽  
Author(s):  
Charles Mve Mvondo ◽  
Paolo Nardi ◽  
Carlo Bassano ◽  
Fabio Bertoldo ◽  
Susanna Grego ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Ascending Aorta ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Aorta Aneurysm

scholarly journals Developmental changes in bicuspid aortic valve and associated aortopathy in small children

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Boesgaard Norsk ◽  
A S Sillesen ◽  
A Axelsson Raja ◽  
M Munk Paerregaard ◽  
C Pihl ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Flow Velocity ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Early Years ◽  
Z Score ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Valve Annulus

Abstract Background The prevalence of bicuspid aortic valve (BAV) in newborns is 0.8%. BAV is associated with an increased risk of aortic valve dysfunction and aortopathy. Aortopathy with increased aortic diameters has recently been reported in newborns with BAV. As most patients with BAV are diagnosed in adulthood the development of BAV and associated aortopathy during early years of life is not well described. Purpose The purpose of the study was to assess changes in aortic valve function and aortic dimensions at two to four years of age in children diagnosed with BAV neonatally. Methods Children with BAV were included from a population-based cohort study, in which newborns (n≈25,000) underwent standardized transthoracic echocardiography (TTE). Follow-up TTE was performed and analyzed according to established guidelines. Neonatal (baseline) and follow-up data were compared. Diameters were indexed to body surface area (BSA). Z-scores were calculated using formulas from the Pediatric Heart Network Echocardiogram Database. Results At follow-up 101 newborns with BAV (mean age 2 years 5 months, SD 11 months), 75% male) were examined from May 2019 to April 2021. From baseline to follow-up there was an increase in the BSA-adjusted diameter of the aortic valve annulus (z-score −0.19 at baseline vs 0.95 at follow up, p<0.001), and of the sino-tubular junction (z-score 0.16 at baseline vs 0.43 at follow up, p<0.05). Conversely, there was a decrease in the Z-score for the diameter measured 1 cm from the valve annulus (z-score 1.31 at baseline vs 0.68 at follow up, p<0.001) and at the widest point of the visualized ascending aorta (z-score 2.44 at baseline vs 1.45 at follow up, p<0.001). There was no significant change in the diameter of the sinus of Valsalva (z-score 0.83 at baseline vs 0.80 at follow up, p=0.92). The number of children with at least one aortic z-score >3 was 31 (30.6%) at baseline and 17 (17.8%) at follow up. At baseline mild aortic valve regurgitation was observed in 18 children (17.8%) and in 23 children at follow up (23%). Mean maximum systolic velocities across the aortic valve were 1.03 m/s at baseline (SD 0.24) and 1.11 m/s at follow up (SD 0.27), p<0.05. Aortic stenosis, defined as flow velocity >2.5 m/s was seen in one child both at baseline and at follow-up. Conclusion In children diagnosed with BAV neonatally, re-examination at the age of 2.5 years showed significant increases in the diameter of the aortic valve annulus and the sino-tubular junction, but a significant decrease in the diameter of the ascending aorta. The maximum blood flow velocity across the aortic valve increased and more children had developed mild aortic valve regurgitation. Thus, the bicuspid aortic valve and the associated aortopathy seem to undergo remodeling during early childhood. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Danish Children's Heart Foundation, Boernehjertefonden.

scholarly journals Impact of Mild Aortic Valve Disease on Late Outcomes after Replacement of the Ascending Aorta Case-control Study

2021 ◽  
Author(s):  
Ken Nakamura ◽  
Kouan Orii ◽  
Taichi Kondo ◽  
Mitsutaka Nakao ◽  
Makoto Wakatabe ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Aortic Valve Disease ◽  
Ascending Aorta ◽  
Valve Disease ◽  
Aortic Valve Area ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Tricuspid Aortic Valve ◽  
Valve Area

Abstract Background: The time course of mild aortic valve disease after replacement of the ascending aorta is unclear. We sought to clarify it.Methods: Between January 2011 and December 2016, 26 patients (9 bicuspid and 17 tricuspid aortic valve disease) underwent replacement of the enlarged ascending aorta alone. We compared the postoperative disease course between bicuspid and tricuspid aortic valve by transthoracic echocardiography and computed tomography performed at 73 ± 23 and 60 ± 23 months post-surgery, respectively.Results: The bicuspid group was younger than the tricuspid group (62.1 ± 4.8 vs 73.3 ± 4.8 years). Pathophysiology predominantly involved aortic valve stenosis and regurgitation in the bicuspid and tricuspid group, respectively. The peak and mean pressure gradient increased (P = .16, and P = .46) and the aortic valve area decreased significantly in the bicuspid group (P = .005). Two patients in the bicuspid group who required re-operation had an aortic valve area of 1.2 cm2 at initial operation. Seventy percent of patients in the tricuspid group had less than mild aortic valve regurgitation preoperatively, which improved up to 82% at follow-up. Freedom from re-operation was 66.7% and 100% at 8 years for the bicuspid and tricuspid group, respectively. Conclusions: Aortic valve replacement may be considered for patients with bicuspid aortic valve stenosis if the aortic valve area is less than 1.2 cm2, even if the general diagnosis is mild aortic valve stenosis at initial surgery. Even mild aortic valve regurgitation may be improved by surgical intervention in the ascending aorta.

Painless limited dissection of the ascending aorta presenting with aortic valve regurgitation

1999 ◽  
Vol 17 (7) ◽  
pp. 700-701 ◽  
Author(s):  
Syed I Rahmatullah ◽  
Ijaz A Khan ◽  
Vinod M Nair ◽  
Nicholas D Caccavo ◽  
Balendu C Vasavada ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ascending Aorta ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation

scholarly journals Surgical Treatment of Aortic Valve Regurgitation due to Infective Endocarditis Associated with Congenital Quadricuspid Aortic Valve

2004 ◽  
Vol 33 (4) ◽  
pp. 306-308 ◽  
Author(s):  
Yuhei Saitoh ◽  
Masaki Aota ◽  
Hiroyuki Koike ◽  
Hanae Uekusa ◽  
Takeichiro Nakane ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Quadricuspid Aortic Valve ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation

scholarly journals A Case of One-Stage Surgical Treatment for Chronic Mesenteric Ischemia Associated with Severe Aortic Valve Regurgitation and Stenosis

2017 ◽  
Vol 46 (6) ◽  
pp. 334-338
Author(s):  
Ryo Kanamoto ◽  
Takahiro Shojima ◽  
Kanako Sakurai ◽  
Mau Amako ◽  
Hiroyuki Otsuka ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Mesenteric Ischemia ◽  
Chronic Mesenteric Ischemia ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
One Stage

Acute Dilatation of the Ascending Aorta and Aortic Valve Regurgitation in Loeys-Dietz Syndrome

2014 ◽  
Vol 97 (6) ◽  
pp. 2188-2190 ◽  
Author(s):  
Tomohiro Nakajima ◽  
Kazutoshi Tachibana ◽  
Yasuko Miyaki ◽  
Nobuyuki Takagi ◽  
Takayuki Morisaki ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ascending Aorta ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation

Prevalence of aortic valve regurgitation in a large population-based study of newborns

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Farooqui ◽  
J.K Bjerrekaer ◽  
M.F Boerresen ◽  
R.O Voegg ◽  
C.A Pihl ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Population Based ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Large Cohort ◽  
Funding Source ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
True Prevalence

Abstract Background Congenital aortic valve regurgitation (AVR) has been estimated to be present in 0.25 per 1,000 live births globally. The true prevalence in an unselected large-scale cohort remains unknown. Presence of congenital AVR could indicate a structural valve abnormality and may result in long-term strain on the heart. Aim To find the true prevalence of AVR in a large cohort of unselected newborns. Methods Between April 2016 and October 2018, 25,752 newborns were consecutively included in a population-based prospective multicenter cohort and examined with transthoracic echocardiography within the first 30 days of life. Examinations with AVR were categorized as trivial AVR by the presence of a trivial diastolic transvalvular flow, or as non-trivial AVR by the presence of a significantly larger and visually observable transvalvular flow. In newborns with non-trivial AVR, the vena contracta, the duration of the transvalvular flow, and the duration of the diastole were measured. The cases were matched 1:4 with newborns with no AVR based on sex, gestational age at birth, birth weight and age at time of examination. Results AVR was identified in 329 newborns (1.3%). Of these, 260 were classified as trivial AVR, 69 (0.27%) were non-trivial AVR. Non-trivial AVR had significantly larger aortic roots at all points of measurement compared to controls (mean±SD): aortic valve annulus (7.3 (0.73) vs. 7.0 (0.63) mm), Sinus of Valsalva (10.3 (1.0) vs. 9.7 (1.0) mm), sino-tubular junction (8.4 (0.8) vs. 8 (0.8) mm), and ascending aorta (10 (0.9) vs. 9.4 (1.1) mm) (p<0.01 for all). Left ventricular dimensions and function did not significantly differ between the cases and controls. The presence of a non-trivial AVR was highly associated with a bicuspid aortic valve (9 (13.0%) vs. 3 (1.1%), p<0.001). Conclusions We found a prevalence of congenital AVR of 1.3% in a large cohort of unselected newborns, which is higher than previously reported. One in five of all AVR found were classified as non-trivial. Newborns with non-trivial AVR presented with larger aortic root and ascending aorta dimensions. Newborns with non-trivial AVR also had a ten-fold higher occurrence of bicuspid aortic valve compared to controls. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Hjerteforeningen

scholarly journals Redo aortic valve reconstruction as saving surgery in a patient with severe rheumatoid cardiac disease.

2021 ◽  
Vol 2 (2) ◽  
pp. 130-134
Author(s):  
Pedro Rojas ◽  
Josué Sisniegas ◽  
Cristian Aguilar ◽  
Necemio Aranda ◽  
Josías Ríos
Keyword(s):  
Rheumatoid Arthritis ◽  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Cardiac Disease ◽  
Prosthetic Valve ◽  
Subaortic Stenosis ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Valve Reconstruction

The combination of aortic valve regurgitation, rheumatoid aortitis, and subaortic stenosis is not frequent in patients with rheumatoid arthritis. Moreover, the surgical treatment of these entities may be challenging with non-adequate results. We report a case of a patient with severe aortic valve regurgitation, inaccessible aortic root secondary to rheumatoid aortitis, and severe subaortic stenosis initially treated by aortic valve replacement. We reoperated the patient due to acute prosthetic valve failure performing an aortic valve reconstruction using bovine pericardium and Ozaki’s technique with good outcomes.

Sign in / Sign up

Export Citation Format

Share Document