scholarly journals Modified conduit preparation creates a pseudosinus in an aortic valve–sparing procedure for aneurysm of the ascending aorta

1995 ◽  
Vol 109 (6) ◽  
pp. 1049-1058 ◽  
Author(s):  
Richard P. Cochran ◽  
Karyn S. Kunzelman ◽  
A.Craig Eddy ◽  
Bradley O. Hofer ◽  
Edward D. Verrier
Keyword(s):  
Aortic Valve ◽  
Ascending Aorta ◽  
Valve Sparing

scholarly journals Pirmosios aortos vožtuvą išsaugančios operacijos šalinant kylančios aortos aneurizmas Vilniaus universiteto Širdies chirurgijos centre

2007 ◽  
Vol 5 (4) ◽  
pp. 0-0
Author(s):  
Vytautas Sirvydis ◽  
Saulius Raugelė ◽  
Arimantas Grebelis ◽  
Gintaras Turkevičius ◽  
Rimantas Karalius ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Marfan Syndrome ◽  
Heart Surgery ◽  
Anticoagulation Therapy ◽  
Ascending Aorta ◽  
University Hospital ◽  
Aorta Aneurysm ◽  
Valve Sparing ◽  
Vilnius University ◽  
Surgery Center

Vytautas Sirvydis1,  Saulius Raugelė1, Arimantas Grebelis1,  Gintaras Turkevičius2, Rimantas Karalius1, Rasa Čypienė1, Palmyra Semėnienė11 Vilniaus universiteto Širdies chirurgijos centras2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Šiuolaikinė kardiochirurgija leidžia radikaliai chirurgiškai gydyti Marfano sindromu sergančius ligonius, kuriems diagnozuojama kylančios aortos aneurizma. Vienas iš pirmųjų metodų buvo sukurtas ir aprašytas Benthallio ir DeBono 1968 m., o 1992 m. Davidas aprašė operaciją, kurios metu išsaugomas natūralus aortos vožtuvas. Vėliau ši technika tobulinta, sukurta dar keletas panašių būdų. Nors ši metodika, atrodytų, leidžia išspręsti keletą problemų, tokių kaip antikoaguliantų vartojimas, tačiau diskusijų tebekelia jos naudojimas esant Marfano sindromui, kai aneurizma yra didesnė nei 50–55 mm. Supažindiname su pirmosiomis sėkmingomis aortos vožtuvą išsaugančiomis operacijomis šalinant kylančios aortos aneurizmas. Ligoniai ir metodai 2003–2006 m. Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centre atliktos keturios izoliuotos Davido I tipo operacijos Marfano sindromu sergantiems ligoniams, turintiems kylančios aortos lėtinę aneurizmą. Operuota dvi moterys ir du vyrai, amžiaus vidurkis 32,5 ± 5,7 m., visi buvo NYHA II funkcinės klasės. Retrospektyviai surinkti širdies echoskopijos duomenys iki ir po operacijos. Rezultatai Ritmo sutrikimų ar kitų grėsmingesnių komplikacijų, mirčių nebuvo. Aortos matmenys tiek ties sinotubuline jungtimi, tiek kylančios dalies skyrėsi statistiškai reikšmingai ir smarkiai, aortos vožtuvo nesandarumo nebuvo arba buvo menkas. Išvados Marfano sindromu sergantiems ligoniams, turintiems lėtinę kylančios aortos aneurizmą, aortos vožtuvą išsaugančios operacijos yra užtektinai saugus gydymo metodas. Literatūros ir mūsų duomenimis, šio tipo operacijos gali būti atliktos, kol aneurizmos dydis yra 50–55 mm ir nėra reikšmingo aortos vožtuvo nesandarumo. Pagrindiniai žodžiai: Marfano sindromas, aortos aneurizma, Davido operacija First experience of aortic valve sparing procedures in patients with aneurysm of ascending aorta at Vilnius University Hospital Santariškių Klinikos Heart Surgery Center Vytautas Sirvydis1,  Saulius Raugelė1, Arimantas Grebelis1,  Gintaras Turkevičius2, Rimantas Karalius1, Rasa Čypienė1, Palmyra Semėnienė11 Heart Surgery Center of Vilnius University2 Vilnius University Hospital Santariškių Klinikos Heart Surgery Center,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objectives The methods of modern cardiac surgery allow to perform a thoroughgoing treatment of ascending aorta aneurysm. Benthall and DeBono in 1968 were the first to describe the basic surgical technique; in 1992 David reported a novel surgical procedure aimed to spare the native aortic valve. The latter technique is superior because of permanent anticoagulation therapy exclusion, but also it is controversial in cases when ascending aorta aneurysm exceeds 55 mm, especially in patients with Marfan syndrome. We would like to introduce our first experience in treating ascending aorta aneurysm and sparing the aortic valve in patients with Marfan syndrome. Patients and methods There were 4 successful cases of David I procedure during 1996–2006 at Vilnius University Hospital Santariškių Klinikos Heart Surgery Center. The patients were 2 male and 2 female, mean age 32.5 ± 5.7 years; all were of NYHA II functional class. Data were collected retrospectively from case histories. Results There were no deaths of any rhythm disturbances after surgery. The parameters of the ascending aorta and aortic root were significantly different as compared with preoperative data. Also, after surgery there were no aortic insufficiency or it was trivial. Conclusions The aortic valve sparing procedure in patients with Marfan syndrome and ascending aorta aneurysm appears to be a safe method of treatment. According to the literature and our data, these operations are safe and effective when the aneurysm does exceed 55 mm and there is no aortic valve insufficiency. Key words: aortic aneurysm, Marfan syndrome, David procedure

scholarly journals Aortic root reimplantation procedure: a new milestone in aortic valve-sparing operations

2016 ◽  
Vol 20 (2) ◽  
pp. 49
Author(s):  
A. M. Chernyavskiy ◽  
D. S. Khvan ◽  
S. A. Alsov ◽  
D. A. Sirota ◽  
M. M. Lyashenko
Keyword(s):  
Aortic Valve ◽  
Conflict Of Interest ◽  
Aortic Root ◽  
Aortic Insufficiency ◽  
Ascending Aorta ◽  
Long Term Follow Up ◽  
Valve Sparing ◽  
Reimplantation Procedure

<p><strong>Aim:</strong> Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency.<br /><strong>Methods:</strong> 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60) months. The average age of patients was 57±13 (23-73) years 56±13 years.<br /><strong>Results:</strong> The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2). Long-term follow-up revealed no valve-associated complications.<br /><strong>Conclusion:</strong> The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.</p><p><strong>Key words:</strong> aortic aneurysm; aortic valve; valve-sparing operations.</p><p><strong>Funding</strong></p><p>The study had no sponsorship.</p><p><strong>Conflict of interest</strong></p><p>The authors declare no conflict of interest.</p>

Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta

2002 ◽  
Vol 74 (5) ◽  
pp. S1758-S1761 ◽  
Author(s):  
Tirone E David ◽  
Joan Ivanov ◽  
Susan Armstrong ◽  
Christopher M Feindel ◽  
Gary D Webb
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Valve Sparing

scholarly journals Early results of valve-sparing ascending aortic replacement in type A aortic dissection and aortic insufficiency

2016 ◽  
Vol 20 (2) ◽  
pp. 35 ◽  
Author(s):  
M. L. Gordeev ◽  
V. E. Uspenskiy ◽  
G. I. Kim ◽  
A. N. Ibragimov ◽  
T. S. Shcherbinin ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Regurgitation ◽  
Type A ◽  
Aortic Insufficiency ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Aortic Replacement ◽  
Ascending Aortic Replacement ◽  
Valve Sparing

<p><strong>Aim:</strong> The study was designed to investigate predictors of effective valve-sparing ascending aortic replacement in patients with Stanford type A aortic dissection combined with aortic insufficiency and to analyze efficacy and safety of this kind of surgery.<br /><strong>Methods:</strong> From January 2010 to December 2015, 49 patients with Stanford type A aortic dissection combined with aortic insufficiency underwent ascending aortic replacement. All patients were divided into 3 groups: valve-sparing procedures (group 1, n = 11), combined aortic valve and supracoronary ascending aortic replacement (group 2, n = 12), and Bentall procedure (group 3, n = 26). We assessed the initial status of patients, incidence of complications and efficacy of valve-sparing ascending aortic replacement.<br /><strong>Results:</strong> The hospital mortality rate was 8.2% (4/49 patients). The amount of surgical correction correlated with the initial diameter of the aorta at the level of the sinuses of Valsalva. During the hospital period, none of patients from group 1 developed aortic insufficiency exceeding Grade 2 and the vast majority of patients had trivial aortic regurgitation. The parameters of cardiopulmonary bypass, cross-clamp time and circulatory arrest time did not correlate with the initial size of the ascending aorta and aortic valve blood flow impairment, neither did they influence significantly the incidence and severity of neurological complications. The baseline size of the ascending aorta and degree of aortic regurgitation did not impact the course of the early hospital period.<br /><strong>Conclusions:</strong> Supracoronary ascending aortic replacement combined with aortic valve repair in ascending aortic dissection and aortic regurgitation is effective and safe. The initial size of the ascending aorta and aortic arch do not influence immediate results. The diameter of the aorta at the level of the sinuses of Valsalva and the condition of aortic valve leaflets could be considered as the limiting factors. Further long-term follow-up is needed.</p><div class="well well-small"><strong>Funding</strong></div><p><strong></strong> The study has been performed within the framework of the 2015-2017 government task, “Cardiovascular diseases” platform, Theme No. 4 Research on genome/cellular mechanisms responsible for aorta/aortic valve pathology development and elaboration of new methods of its multimodality treatment including hybrid technologies.<br /><strong></strong></p><p><strong>Conflict of interest</strong></p><p><strong></strong>The authors declare no conflict of interest.</p><p><strong>Acknowledgement</strong></p><p>The authors express their deep gratitude for assistance in diagnostics and management of patients with aortic pathologies, as well as in preparation of this article to A.Yu. Bakanov, PhD, Head of Research Laboratory of Perfusiology and Cardiac Protection; V.V. Volkov, Fellow of Research Laboratory of Perfusiology and Cardiac Protection; A.V. Naymushin, PhD, Head of Anesthesiology &amp; Resuscitation/ICU-2 Department; I.V. Basek, Phd, Head of X-Ray Computer Tomography Department and the specialists of X-Ray Computer Tomography Department, as well as to the employees of Research Center for Non-Coronary Heart Diseases and to specialists of cardiovascular surgery departments.</p>

Ascending aorta and aortic root replacement (with or without valve sparing) in early childhood: surgical strategies and long-term outcomes

2019 ◽  
Author(s):  
Anne Moreau de Bellaing ◽  
Margaux Pontailler ◽  
Fanny Bajolle ◽  
Régis Gaudin ◽  
Bari Murtuza ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Young Children ◽  
Marfan Syndrome ◽  
Aortic Root ◽  
Surgical Techniques ◽  
Ascending Aorta ◽  
Long Term Results ◽  
Short Period ◽  
Valve Sparing

AbstractOBJECTIVESAortic root and ascending aorta replacements (AARs) are rarely required in the paediatric population. We report here a series of AAR performed in young children using different surgical techniques.METHODSBetween 1995 and 2017, 32 children under the age of 10 years (median age 5.4 years) underwent AAR procedures at our institution. Twenty-two (69%) had a connective tissue disease (infantile Marfan syndrome or Loeys–Dietz syndrome). We performed 11 AAR using a composite graft with a mechanical prosthesis and 21 valve-sparing procedures (10 Yacoub operations and 11 David operations). Median follow-up for operative survivors was 7.7 years (interquartile range 4.2–12.8 years).RESULTSThe cardiac-related early mortality rate was 6%. Patient survival was 91% at both 1 and 10 years. Eleven survivors (38%), all with a status of post-valve-sparing procedure, required an aortic root reintervention with an aortic valve replacement after a median interval of 4.2 years. Interestingly, only patients with infantile Marfan syndrome tended to be associated with risk of reoperation.CONCLUSIONSAortic root and AARs are safe in young children whatever the surgical procedure. Aortic valve-sparing procedures show good long-term results except in children with infantile Marfan syndrome whose ineluctable aortic annulus dilatation or aortic valve regurgitation requires reintervention after a short period.

Aortic Valve-Sparing Operation in Dilatation of the Ascending Aorta

2010 ◽  
Vol 15 (6) ◽  
pp. 434-436
Author(s):  
René Prêtre ◽  
Marko I. Turina
Keyword(s):  
Aortic Valve ◽  
Ascending Aorta ◽  
Valve Sparing

scholarly journals Aortic valve–sparing reimplantation for dilatation of the ascending aorta and aortic regurgitation late after repair of congenital heart disease

2007 ◽  
Vol 133 (4) ◽  
pp. 876-879 ◽  
Author(s):  
Masamichi Ono ◽  
Heidi Goerler ◽  
Klaus Kallenbach ◽  
Dietmar Boethig ◽  
Mechthild Westhoff-Bleck ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Congenital Heart ◽  
Ascending Aorta ◽  
Valve Sparing

scholarly journals Valve-sparing operations on the aortic valve and the ascending aorta: radical correction of congenital and acquired heart diseases. Immediate outcomes

2021 ◽  
Vol 23 (1) ◽  
pp. 84-90
Author(s):  
G. A. Akopov ◽  
T. N. Govorova ◽  
A. S. Ivanov
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Heart Diseases ◽  
Ascending Aorta ◽  
Artificial Organs ◽  
Tricuspid Valve Repair ◽  
Type I ◽  
Aortic Valves ◽  
Valve Sparing ◽  
Aortic Valve Reimplantation

This paper presents the immediate outcomes of valve-sparing operations on the aortic valve and ascending aorta in radical correction of congenital and acquired heart disease. Materials and methods. The study enrolled 50 patients with aortic insufficiency who were operated upon at Shumakov National Medical Research Center of Transplantology and Artificial Organs from 2011 to 2019. The mean age was 48 ± 16 years, 64% of them were men (n = 32). The study included patients with tricuspid (n = 36, 72%) and bicuspid (n = 14, 28%) aortic valves. Aortic valve reimplantation was performed in 32 (64%) patients, aortic root remodeling - in 1 (2%). 17 (34%) patients had no aortic root reconstruction or remodeling. Aortic valve reimplantation was done in 4 (8%) cases in combination with coronary artery bypass grafting, and in 4 (8%) with mitral and tricuspid valve repair. Results. Thirty-day mortality was 0%. In 1 case (2%), a permanent pacemaker was installed due to complete atrioventricular block. There were no neurological and coronary events, and cases of endocarditis. In all patients (100%), aortic valve insufficiency after surgical correction did not exceed grade 1 according to echocardiographic follow-up examination. On aortic valve mean and peak gradients were 8 ± 6 and 15 ± 7 mm Hg, respectively. Findings. Type I and II valve-sparing reconstructive surgery (for bicuspid and tricuspid aortic valves) is an excellent alternative to prosthetic repair with great postoperative outcomes, low valve-associated complications and low mortality. 

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