Commentary: Aortic Valve Reconstruction: Embrace it and master it… for your patients’ sake… and your future

Replacements for diseased aortic valves are limited. Repair of the aortic valve is performed by only a few surgeons. A novel technique of aortic valve reconstruction using autologous pericardium shows promising results. In this video tutorial, we demonstrate the Ozaki procedure using an ex vivo low fidelity simulation.

Download Full-text

Excellent Hemodynamic Results in Patients Undergoing the Ozaki Procedure for Aortic Valve Reconstruction within the First Year

10.1055/s-0039-1678893 ◽

2019 ◽

Author(s):

M. Krane ◽

J. Boehm ◽

A. Prinzing ◽

R. Lange

Keyword(s):

Aortic Valve ◽

First Year ◽

Valve Reconstruction

Download Full-text

History of the use of autologous materials in aortic valve surgery

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-3-106-115 ◽

2021 ◽

Vol 25 (3) ◽

pp. 106

Author(s):

R. N. Komarov ◽

A. O. Simonyan ◽

I. A. Borisov ◽

V. V. Dalinin ◽

A. M. Ismailbaev ◽

...

Keyword(s):

Aortic Valve ◽

Heart Valve ◽

Heart Valves ◽

Surgical Techniques ◽

Valve Surgery ◽

Aortic Valve Surgery ◽

Short Service Life ◽

Wide Range ◽

Valve Reconstruction ◽

History Of

Various types of autologous materials are used in heart valve surgery, particularly the aortic valve, and this article describes their historical development. The evolution of the use of various autogenous tissues, such as the aortic wall, fascia lata of the thigh, pericardium and others is described and discussed in detail. This paper presents the results of experimental and clinical publications devoted to the surgical techniques and the outcomes of heart valve reconstruction using such materials. The negative aspects of the use of a wide range of autografts are discussed, including the short service life and low strength, which led to declining interest in this group of reconstructive interventions. The method for treating the autopericardium with glutaraldehyde, proposed in 1986 by C.S. Love, J.W. Love and colleagues, raised the use of autologous materials in the reconstruction of heart valves to a new level, allowing surgeons to strengthen the autopericardial flaps and increase resistance to hemodynamic stress. Many surgeons, their interest in such treatment methods increased by this discovery, then reported their observations and further developed ways of using the treated autopericardium in aortic valve surgery. Particularly, the method of neocuspidisation of the aortic valve, introduced into wide practice by M.G. Duran and S. Ozaki, has become the quintessential reconstructive valve surgery involving the use of autologous materials.Received 14 March 2021. Revised 26 April 2021. Accepted 27 April 2021.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors Conception and study design: A.O. Simonyan, A.M. Ismailbaev Drafting the article: A.O. Simonyan, A.M. Ismailbaev, N.O. Kurasov, M.I. Tcheglov Critical revision of the article: R.N. Komarov, V.V. Dalinin, I.A. Borisov Final approval of the version to be published: R.N. Komarov, A.O. Simonyan, I.A. Borisov, V.V. Dalinin, A.M. Ismailbaev, N.O. Kurasov, M.I. Tcheglov

Download Full-text

Abstract 12381: Advantage of Aortic Valve Reconstruction in Dynamic Changes of Aortic Annulus Assessed by Speckle Tracking Echocardiography After Aortic Valve Surgery

Circulation ◽

10.1161/circ.130.suppl_2.12381 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Go Hashimoto ◽

Makoto Suzuki ◽

Hisao Yoshikawa ◽

Takenori Otsuka ◽

Yukiko Isekame ◽

...

Keyword(s):

Aortic Valve ◽

Speckle Tracking ◽

Cardiac Cycle ◽

Aortic Annulus ◽

Control Group ◽

Dynamic Changes ◽

Significant Difference ◽

Valve Reconstruction ◽

Cyclic Changes ◽

Annulus Diameter

Introduction: It is reported that aortic valve reconstruction (AVrC) by using autologous pericardium is useful in patients with various aortic valve diseases. This method may be more effective in preserving the natural motion of the aortic valve annulus. Significant dynamic changes in the aortic annulus have previously been reported in animal models and clinical studies. The purpose of this study is to analize the cyclic changes of the aortic annulus using speckle-tracking trans-esophageal echocardiography in patients who underwent AVrC surgery. Methods: The subjects were 35 patients underwent AVrC surgery for aortic regurgitation or aortic stenosis and 40 controls. Cyclic aortic annulus diameter of the maximum and minimum diameters were determined from a speckle-tracking displacement curve (figure). These data was used to calculate the absolute change in the diameter of the aortic annulus, which was defined as the difference in diameters throughout the cardiac cycle. Results: There was significant difference between maximum and minimum aortic annulus diameter in AVrC group (18.7±3.0 mm vs 16.1±2.9 mm, p<0.0001). There was significant difference in the maximum and minimum aortic annulus diameter in control group (22.9±2.7 mm vs 20.0±2.9 mm, p<0.0001). AVrC group had significant cyclic change of aortic annulus as same as control group (AVrC group : 2.6±1.0 mm vs control group : 2.9±0.7 mm, p= NS). Conclusions: Our study suggests that dynamic changes of the aortic annulus occur in the cardiac cycle and can be measured using speckle-tracking trans-esophageal echocardiography. AVrC may preserve the coordination of the left ventricle, aortic annulus, sinus of Valsalva and aorta compared with conventional aortic valve replacement.

Download Full-text