scholarly journals The Normal Aortic Valve Leaflets Effective Height in Pediatric Patients: a Guide to Aortic Valve Repair

2021 ◽  
Author(s):  
Ismail Bouhout ◽  
Vincent Chauvette ◽  
Wu Rong ◽  
Marie Josée Raboisson ◽  
Ismail El-Hamamsy ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pediatric Patients ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Effective Height ◽  
Aortic Valve Leaflets

Long-Term Outcomes after Aortic Valve Repair in Pediatric Patients

2021 ◽  
Author(s):  
J. Schlein ◽  
D. Wiedemann ◽  
H. Gabriel ◽  
G. Wollenek ◽  
P. Simon ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pediatric Patients ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Long Term Outcomes

Aortic Valve Repair for Adult Congenital Heart Disease

Circulation ◽  
2000 ◽  
Vol 102 (suppl_3) ◽  
Author(s):  
Vivek Rao ◽  
Glen S. Van Arsdell ◽  
Tirone E. David ◽  
Anthony Azakie ◽  
William G. Williams
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Aortic Valve ◽  
Congenital Heart ◽  
Septal Defect ◽  
Aortic Valve Repair ◽  
Subaortic Stenosis ◽  
Valve Repair ◽  
Aortic Valve Leaflets

Background —Aortic valve–preserving procedures have resulted in excellent outcomes in selected patients, particularly those with normal aortic valve leaflets and dilated aortic roots. However, several congenital heart lesions are associated with abnormal aortic valve leaflets. The long-term results of aortic valve repair for these lesions are not well defined. Methods and Results —We reviewed the clinical records of 54 adult (age >18 years) patients who underwent repair of congenital abnormalities of the aortic valve between 1976 and September 1999. Follow-up data were available on 52 (96%) patients (mean 50±67 months, range 1 to 266). Patients underwent repair at a mean age of 34±14 years with associated diagnoses of subaortic stenosis (n=10), ventricular septal defect with prolapsing aortic valve (n=17), bicuspid aortic valve (n=23), sinus of Valsalva aneurysm (n=10), and bacterial endocarditis (n=2). There was 1 operative death (1.9%) and 3 late deaths. Survival at 5 and 10 years was 98±2% and 74±12%, respectively. Freedom from reoperation was 74±9% and 51±15% at 5 and 10 years, respectively. The presence of a ventricular septal defect predicted failure of valve repair (59% versus 22%, P =0.01). A bicuspid aortic valve, subaortic stenosis, or the requirement for mitral valve surgery did not affect outcomes. Conclusions —Aortic valve repair in adult patients with congenital heart disease can be performed with minimal morbidity and mortality rates. The medium-term results of repair are acceptable, regardless of valvular or associated pathology. However, only 31 patients (57%) demonstrated long-term competence of the aortic valve, suggesting that most adult patients with congenital aortic valve disease will eventually require aortic valve replacement.

Cusp-based geometric height-oriented repair of a pediatric aortic valve

2020 ◽  
Keyword(s):  
Aortic Valve ◽  
Septal Defect ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Basal Ring ◽  
Sinotubular Junction ◽  
Effective Height ◽  
Institutional Experience ◽  
Conotruncal Anomalies ◽  
Geometrical Concepts

Progressive aortic regurgitation can occur in pediatric patients due to root dilation with conotruncal anomalies or cusp prolapse associated with a ventricular septal defect. It is treated using various approaches influenced by personal preferences and institutional experience. We applied geometrical concepts developed for adult aortic valve repair to pediatric valves. The basal ring and sinotubular junction are downsized in relation to the geometric height of the cusp by external suture annuloplasty. The length of the cusp free margin is then adjusted with central plication, guided by measuring the effective height of the cusp. This approach facilitates the reproducibility and predictability of pediatric aortic valve repair.

scholarly journals Aortic root numeric model: Annulus diameter prediction of effective height and coaptation in post–aortic valve repair

2013 ◽  
Vol 145 (2) ◽  
pp. 406-411.e1 ◽  
Author(s):  
Gil Marom ◽  
Rami Haj-Ali ◽  
Moshe Rosenfeld ◽  
Hans Joachim Schäfers ◽  
Ehud Raanani
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Effective Height ◽  
Numeric Model ◽  
Annulus Diameter

scholarly journals THE NORMAL AORTIC ROOT AND CUSP CONFIGURATION IN PEDIATRIC PATIENTS: GUIDE TO A SUCCESSFUL AORTIC VALVE REPAIR

2019 ◽  
Vol 35 (10) ◽  
pp. S103
Author(s):  
I. Bouhout ◽  
W. Rong ◽  
N. Poirier ◽  
N. Dahdah ◽  
I. El-Hamamsy ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Pediatric Patients ◽  
Aortic Valve Repair ◽  
Valve Repair

scholarly journals Relationship Between Leaflets and Root in Normal Aortic Valve Based on Computed Tomography Imaging: Implication for Aortic Valve Repair

2021 ◽  
Vol 8 ◽  
Author(s):  
Tianyang Yang ◽  
Haini Wen ◽  
Ismail El-Hamamsy ◽  
Qiming Ni ◽  
Yanbin Sun ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Aortic Root ◽  
Three Dimensional ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Effective Height ◽  
The Mean ◽  
The Relationship ◽  
Annulus Diameter

Objective: By assessing the normal dimensions and the relationship between the aortic root and leaflets in Chinese population, the objective of this three-dimensional computed tomography (3DCT)-based study was to establish a matching reference for leaflets and aortic root for aortic valve (AV) repair.Method: Electrocardiogram-gated multi-detector CT was performed on 168 Chinese participants with a normal aortic valve. Measurements of the aortic annuli and leaflets were obtained. The correlations between and the ratios of the specific root and leaflet measurements were analyzed. The references for the leaflet and root dimensions were suggested based on geometric height (gH) using a linear regression equation. The utility of the ratios was tested with CT images of 15 patients who underwent aortic valve repair.Result: The mean annulus diameter (AD), sino-tubular junction (STJ) diameter, geometric height (gH), effective height (eH), free margin length (FML), commissural height (ComH), inter-commissural distance (ICD), and coaptation height (CH) were 22.4 ± 1.7 mm, 27.3 ± 2, 0.4 mm, 15.5 ± 1.7 mm, 8.9 ± 1.2 mm, 32.0 ± 3.4 mm, 17.9 ± 1.9 mm, 23.1 ± 2.3 mm, and 3.1 ± 0.6 mm, respectively. The gH/AD, FML/ICD, and eH/ComH ratios were 0.69 ± 0.07, 1.38 ± 0.08, and 0.50 ± 0.07, respectively. The gH correlated with all other leaflet and root measurements (P < 0.01), whereas the FML demonstrated a better correlation with ICD compared with gH (R2 = 0.75, and R2 = 0.37, respectively). The FML/ICD and eH/ComH ratios might be used to assess leaflet-root mismatch and post-repair leaflet billowing.Conclusion: The normal aortic valve measurements based on 3DCT revealed a specific relationship between the root and leaflets; and this will guide the development of an objective method of aortic valve repair.

Prevalence of Leaflet Defects during Aortic Valve Repair with Normal and Aneurysmal Aortic Morphology

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
L. Weber ◽  
S. Pfeiffer ◽  
D. Mazzitelli ◽  
J. Rankin ◽  
C. Stamm ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Repair ◽  
Valve Repair ◽  
Aortic Morphology

Quadricuspid Aortic Valve Repair Facilitated by Geometric Ring Annuloplasty

2021 ◽  
pp. 155698452110030
Author(s):  
Joseph A. McGuire ◽  
Heather K. Hayanga ◽  
Jeremiah W. Hayanga ◽  
Daniel Sloyer ◽  
Matthew Ellison ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Patient Outcomes ◽  
Systematic Approach ◽  
Aortic Insufficiency ◽  
Aortic Valve Repair ◽  
Autologous Reconstruction ◽  
Quadricuspid Aortic Valve ◽  
Valve Repair ◽  
Ring Annuloplasty ◽  
Annular Geometry

Quadricuspid aortic valve (QAV) is a rare congenital anomaly often associated with aortic insufficiency. The exact anatomy of QAV is variable, and most cases have undergone aortic valve replacement. With the recognition that aortic valve repair achieves superior patient outcomes as compared to replacement, a systematic approach to autologous reconstruction of QAV is needed. This article reports 2 cases having successful repair utilizing geometric aortic annuloplasty rings, and describes a proposed scheme for repairing most QAV defects, based on relative leaflet and commissural characteristics. Using either tri-leaflet or bicuspid ring annuloplasty, the normal sub-commissural triangles can be remodeled into a 120° or 180° configuration, respectively, and then the leaflets can be sutured and plicated to fit annular geometry. With this approach, most quadricuspid valves potentially could undergo autologous reconstruction.

scholarly journals Comparison of bicuspid and tricuspid aortic valve repair

2020 ◽  
Author(s):  
Radosław Gocoł ◽  
Jarosław Bis ◽  
Marcin Malinowski ◽  
Joanna Ciosek ◽  
Damian Hudziak ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Hazard Ratio ◽  
Aortic Valve Repair ◽  
Pericardial Patch ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Valve Repair ◽  
Tricuspid Aortic Valve ◽  
Valve Annulus ◽  
Annulus Diameter

Abstract   OBJECTIVES The aim of this study was to compare the outcomes of tricuspid aortic valve (TAV) and bicuspid aortic valve (BAV) repair. METHODS We assessed mortality, freedom from reoperation and the rate of aortic valve regurgitation recurrence. Mortality in both groups was compared with expected survival, and risk factors for reoperation were identified. RESULTS From January 2010 to April 2020, a total of 368 elective aortic valve repair procedures were performed, including 223 (60.6%) in patients with TAV. The perioperative mortality was 0.7% in the BAV group and 3.6% in the TAV group (P = 0.079). Estimated survival at 5 years in the BAV versus TAV group was 97 ± 3% vs 80 ± 6%, respectively (P < 0.001). Freedom from reoperation at 5 years in the TAV versus BAV group was 96 ± 3% vs 93 ± 4%, respectively (P = 0.28). Grade 2 or more aortic valve regurgitation was noted in 9.9% of BAV patients and 11% of TAV patients (P = 0.66). Reoperation was predicted by cusp perforation [hazard ratio 15.86 (4.44–56.61); P < 0.001], the use of pericardial patch [hazard ratio 8.58 (1.96–37.53); P = 0.004] and aortic valve annulus diameter >27.5 mm [hazard ratio 3.07 (0.99–9.58); P = 0.053]. CONCLUSIONS BAV repair is as durable as TAV repair. BAV is not a predictor of a higher rate of reoperations. BAV repair yields survival comparable to expected. Cusp perforation, aortic valve annulus diameter >27.5 mm and the use of pericardial patch adversely impact long-term outcome of aortic valve repair.

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