scholarly journals Aortic root replacement after previous surgical intervention on the aortic valve, aortic root, or ascending aorta

2006 ◽  
Vol 131 (3) ◽  
pp. 601-608 ◽  
Author(s):  
E.W. Matthias Kirsch ◽  
N. Costin Radu ◽  
Armand Mekontso-Dessap ◽  
Marie-Line Hillion ◽  
Daniel Loisance
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Surgical Intervention ◽  
Ascending Aorta ◽  
Aortic Root Replacement

scholarly journals Aortic Root Replacement after Aortic Valve or Ascending Aorta Surgery

2010 ◽  
Vol 5 (3) ◽  
pp. 22-30
Author(s):  
Jos A. Bekkers ◽  
Loes M.A. Klieverik ◽  
Goris Bol Raap ◽  
Johanna J.M. Takkenberg ◽  
Ad J.J.C. Bogers
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Aortic Root Replacement

scholarly journals Aortic root surgery: Early postoperative results of different surgical techniques

Medicina ◽  
2009 ◽  
Vol 45 (3) ◽  
pp. 197 ◽  
Author(s):  
Rimantas Benetis ◽  
Eglė Ereminienė ◽  
Povilas Jakuška ◽  
Dainius Karčiauskas ◽  
Šarūnas Kinduris ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Surgical Techniques ◽  
Ascending Aorta ◽  
Aortic Root Replacement ◽  
Postoperative Results ◽  
Aortic Root Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of the study was to evaluate early postoperative results of different surgical techniques of aortic root surgery. Material and methods. Between January 2004 and November 2007, a cohort of 83 patients underwent aortic root surgery in the Heart Center, Hospital of Kaunas University of Medicine. Patients were divided into three groups: Group 1 (18 patients) – reimplantation of the aortic valve within a vascular graft (David operation), Group 2 (48 patients) – replacement of the ascending aorta and aortic valve using a valved conduit (Bentall de Bono operation), and Group 3 (17 patients) – biological aortic root replacement. Study protocol included clinical data, operative data, and postoperative major adverse effects: reoperations for bleeding, stroke and lethal outcomes. Results. Patients undergoing biological aortic root replacement were older as compared with other groups. The mean age in the Group 1 was 50.3±3.5 years vs. 57±2.0 years in the Group 2 and 67.8±3.3 years in the Group 3 (P<0.05). The main indication for the aortic root surgery was the aneurysm of the aortic root and ascending aorta in the Group 1 and 2 patients (64.7% and 72%), while in the Group 3, the main indication was fibrocalcinosis of aortic valve, aortic annulus, and ascending aorta (61.1%). The 30-day hospital mortality rates were as follows: 5.8% (n=1), in the Group 1; 10.4% (n=5), in the Group 2; 5.5% (n=1), in the Group 3. In the early postoperative period, 11 reoperations were performed due to bleeding events: in the Group 1, after planned/emergency surgery (n=2/2), and in the Group 2 (n=1/6), respectively. The function of aortic valve improved significantly in all groups of patients early after surgery. In the Group 1, the degree of aortic regurgitation decreased from 2.5±0.8 to 1.1±0.6 (P<0.05); in the Groups 2 and 3, the mean gradient through the aortic valve decreased from 39.9±7.5 to 17.1±5.3 mm Hg and from 48.8±18.0 to 20.1±11.0 mm Hg, respectively (P<0.05). No reoperation for aortic valve failure before the discharge was required in all groups of patients, and neither thromboembolic complications nor stroke events were noted in any group. Conclusions. Different aortic root surgery techniques showed similar postoperative results. New aortic root surgery methods such as aortic root-preserving/sparing procedures and concurrent aortic valve leaflet repair or aortic root replacement with the bioprosthesis can be selected for a diverse class of aortic root pathology with low perioperative mortality rates and good early postoperative results.

Aortic Root Replacement Using Composite Valve Graft in Patients with Aortic Valve Disease and Aneurysm of the Ascending Aorta: Twenty Years' Experience of Late Results

2002 ◽  
Vol 26 (5) ◽  
pp. 467-473 ◽  
Author(s):  
Shigeyuki Aomi ◽  
Masato Nakajima ◽  
Masaki Nonoyama ◽  
Hideyuki Tomioka ◽  
Yukihiro Bonkohara ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Aortic Valve Disease ◽  
Late Results ◽  
Ascending Aorta ◽  
Aortic Root Replacement ◽  
Valve Disease

scholarly journals 1644 Unusual management of dislodged TAVR prosthesis, Nightmare in Cath lab

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Alnabti ◽  
G Abushahba ◽  
S Abujalala ◽  
E Khalifa ◽  
A M Alkhulaifi ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Root ◽  
Surgical Intervention ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Aortic Annulus ◽  
Lv Function ◽  
Transverse Diameter ◽  
Valve Prosthesis

Abstract Introduction The Trans aortic valve replacement( TAVR) is well established technique that is basically designed for patient with sever aortic stenosis with high surgical risk. We describe a TAVR procedure was complicated with valve dislodgment and treated without surgical intervention Case report 75 year old Female Patient hypertensive, diabetic, Hypothyroidism and Atrial Fibrillation on oral anticoagulation. Her transthoracic echocardiography(TTE) showed sever critical aortic valve stenosis and calculated aortic valve are was 0.6 cm² and Peak gradient is 68mmhg and mean 46 mmHg , sever Left ventricular dysfunction and estimated EF 25 % . The CT Aortogram showed The aortic annulus maximum transverse diameter measures was 30 mm and the anteroposterior diameter was 25 mm. The sinus of Valsalva measures 37 mm was Sino tubular junction measures 24 mm and the proximal ascending aorta measures 39 mm. There is no evidence of coronary artery disease by the CT coronary angiogram. Because of depressed LV function, it was decided to do the TAVR with ECMO (Extra Corporeal Membrane Oxygenation) support. Based on CT measurements, CoreValve29 was selected The native valve is pre dilated then CoreValve29 was advanced. Unfortunately valve was larger than the aortic annulus and during trial to valve deployment ( Fig A) ,valve jumped into proximal ascending aorta in opining position just few centimeters from coronary ostium ( Fig B). We advance balloon for maximum dilatation of core valve 29 to ensure fixation of valve in ascending aorta and complete opening of valve leaflets. A second smaller valve (coreValve26) was advanced through the dislodged valve and crossing through its leaflet of first core valve (which settled in aorta) and successfully reaches the aortic annulus and confirming proper positioning of the coreValve26 and then deployed safely The coreValve26 was deployed in acceptable position and coreValve29 was hooked and well-fixed to 26 valves in proximal ascending aorta (Fig C). Coronary flow was secured and confirmed by aortic root injection (Fig F). Patient kept supported on ECMO before and during the TAVR procedure. The patient tolerated the procedure and was stable hemodynamically throughout the procedure. Successful ECMO weaning and patient hemodynamically remained stable with Total bypass time on ECMO was 142 minutes. Post procedure chest X ray showed two corValves hooked together in aortic root and ascending aorta in (Fig D). Follow up TTE showed improved EF systolic LV function (EF 39 %). Normal functioning aortic valve prosthesis. Conclusion Up to our knowledge, this is the first case that valve dislodgment was treated percutaneously not required urgent surgical intervention. Although it is one case report, however it could open the ideas for new approach how to manage difficult cases with dislodged valve with percutaneous approach. Abstract 1644 Figure.

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Emergency aortic root replacement with the Bioconduit stentless aortic valve conduit

2020 ◽  
Vol 25 (6) ◽  
pp. 2055-2059
Author(s):  
ADRIAN TULIN ◽  
◽  
OVIDIU STIRU ◽  
MIRUNA LUANA MIULESCU ◽  
LAURA RADUCU ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Root ◽  
Aortic Root Replacement ◽  
Bentall Operation ◽  
Severe Aortic Regurgitation ◽  
Valve Conduit ◽  
Successful Case ◽  
Valved Conduit

This report concerns a 73-year-old woman who presented with asymptomatic aortic root an-eurysm with severe aortic regurgitation. The purpose of this article is to present our first successful case for emergency aortic root replacement (Bentall operation) that involves annular implantation of a pericardial valved conduit (Bioconduit TM, Biointegral Surgical, Inc., Ontario, Canada) and to discuss some essential technical clue issues related to this approach.

scholarly journals Geometric changes in aortic root replacement using Freestyle prosthesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Anja Osswald ◽  
Alina Zubarevich ◽  
Arian Arjomandi Rad ◽  
Robert Vardanyan ◽  
Konstantin Zhigalov ◽  
...  
Keyword(s):  
Aortic Root ◽  
Ascending Aorta ◽  
Aortic Root Replacement ◽  
Aortic Annulus ◽  
Strongly Correlated ◽  
Root Volume ◽  
Concomitant Surgery ◽  
Valve Size ◽  
Operative Planning ◽  
Geometric Changes

Abstract Background The Medtronic Freestyle prosthesis has proven to be a promising recourse for aortic root replacement in various indications. The present study aims to evaluate clinical outcomes and geometric changes of the aorta after Freestyle implantation. Methods Between October 2005 and November 2020, the computed tomography angiography (CTA) data of 32 patients were analyzed in a cohort of 68 patients that underwent aortic root replacement using Freestyle prosthesis. The minimum and maximum diameters and areas of the aortic annulus, aortic root, ascending aorta, and the proximal aortic arch were measured at a plane perpendicular to the long axis of the aorta using 3D multiplanar reconstruction in both the preoperative (n = 32) and postoperative (n = 10) CTAs. Moreover, volumetric changes of the aortic root and ascending aorta were quantified. Results Mean age was 64.6 ± 10.6 years. Indications for surgery using Freestyle prosthesis were combined aortic valve pathologies, aortic aneurysm or dissection, and endocarditis, with concomitant surgery occurring in 28 out of 32 patients. In-hospital mortality was 18.6%. Preoperative diameter and area measurements of the aortic annulus strongly correlated with the implanted valve size (p < 0.001). Bicuspid valve was present in 28.1% of the patients. Diameter and areas of the aortic root decreased after freestyle implantation, resulting in a reduction of the aortic root volume (45.6 ± 26.3 cm3 to 18.7 ± 4.5 cm3, p = 0.029). Volume of the aortic root and the ascending aorta decreased from 137.3 ± 65.2 cm3 to 54.5 ± 21.1 cm3 after Freestyle implantation (p = 0.023). Conclusion Implantation of the Freestyle prosthesis presents excellent results in restoring the aortic geometry. Preoperative CTA measurements are beneficial to the surgical procedure and valve selection and therefore, if available, should be considered in pre-operative planning.

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