scholarly journals AUTOMATED QUANTIFICATION OF AORTIC ROOT REMODELING IN AORTIC STENOSIS USING VOLUMETRIC 3-D TRANSESOPHAGEAL ECHOCARDIOGRAPHY: IMPLICATIONS FOR TRANS-CATHETER AORTIC VALVE REPLACEMENT (TAVR)

2011 ◽  
Vol 57 (14) ◽  
pp. E647
Author(s):  
Anna Calleja ◽  
Razvan Ionasec ◽  
Paaladinesh Thavendiranathan ◽  
Shizhen Liu ◽  
Helene Houle ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Transesophageal Echocardiography ◽  
Valve Replacement ◽  
Aortic Root ◽  
Aortic Root Remodeling ◽  
Automated Quantification

scholarly journals Aortic Root Enlargement during Aortic Valve Replacement in Adults

2021 ◽  
pp. 56-62
Author(s):  
Miroslav M. Furman ◽  
Sergey V. Varbanets ◽  
Oleksandr M. Dovgan
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Severe Aortic Stenosis ◽  
Aortic Root Replacement ◽  
Safe Procedure ◽  
Aortic Pathology ◽  
Aortic Root Enlargement

Aortic valve replacement is a gold standard in the treatment of patients with severe aortic stenosis or combined aortic pathology. However, aortic valve pathology is often associated with a narrow aortic orifice, particularly in patients with severe aortic stenosis. In 1978, Rahimtoola first described the term of prosthesis-patient mismatch. He noted that effective orifice area of the prosthesis is smaller than that of the native valve. To minimize this complication, there are several surgical strategies: aortic root enlargement (ARE), implantation of a frameless biological prosthesis in the native position, neocuspidalization procedure, Ross procedure, aortic root replacement with xenograft or homograft. ARE is an excellent option, however, some authors outline additional perioperative risks. The aim. To analyze immediate results of ARE during isolated aortic valve replacement and in cases when it is combined with other heart pathologies. Materials and methods. Our study included 63 patients who underwent ARE. Isolated aortic valve replacement was performed in the majority of cases, but often aortic root replacement procedure was combined with coronary artery bypass grafting. Results and discussion. One of 63 patients died (hospital mortality 1.6%) at an early hospital stage (30 postoperative days). Measurement of the aortic valve ring was performed by two methods, through preoperative echocardiography and perioperative measurement using a valve sizer. However, perioperative dimension was chosen as the basis for the calculations. In 62 patients, the perioperative diameter of the aortic valve ring ranged from 19 to 23 mm, only one patient had a diameter of 24 mm. According to our findings, ARE enabled to achieve an average aortic ring size increase of 2.68 cm2 (from 1.5 to 3.4 cm2) and to prevent prosthesis-patient mismatch in 42 (66.7%) cases. Conclusions. Prosthesis-patient mismatch is considered a serious complication in the postoperative period. Narrow aortic root is a common pathology that should be considered during surgery. ARE is a safe procedure and is not associated with an increased risk of mortality and complications.

Aortic Root Enlargement and Aortic Valve Replacement for Calcified Supravalvular and Valvular Aortic Stenosis in Homozygous Familial Hypercholesterolemia: A Case Report

2019 ◽  
Vol 11 (4) ◽  
pp. NP221-NP225 ◽  
Author(s):  
Ujjwal Kumar Chowdhury ◽  
Abhinavsingh Chauhan ◽  
Suruchi Hasija ◽  
Jhulana Kumar Jena ◽  
Lakshmi Kumari Sankhyan ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Rare Condition ◽  
Mechanical Prosthesis ◽  
Valvular Aortic Stenosis ◽  
Aortic Root Enlargement ◽  
Familial Homozygous Hypercholesterolemia

Familial homozygous hypercholesterolemia is a rare disease with diverse clinical presentations ranging from premature ischemic heart disease to aortic root stenosis but rarely presents with anginal symptoms due to supravalvular and valvular aortic stenosis. We report a 19-year-old male patient with familial homozygous hypercholesterolemia with progressive supravalvular and valvular aortic stenosis that ultimately required aortic root enlargement and aortic valve replacement using a mechanical prosthesis, despite aggressive medical therapy. Surgical importance of this rare condition is highlighted.

scholarly journals Deformational dynamics of the aortic root in elderly patients after aortic valve replacement with biological prostheses

2017 ◽  
Vol 21 (4) ◽  
pp. 31
Author(s):  
D. P. Demidov ◽  
D. A. Astaspov ◽  
A. V. Bogachev-Prokophiev ◽  
S. I. Zheleznev ◽  
A. M. Karaskov
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Conflict Of Interest ◽  
Aortic Root ◽  
Group I ◽  
Stentless Bioprostheses ◽  
Biological Prostheses

<p><strong>Aim.</strong> The study was designed to comparatively assess dynamic changes of the aortic root structures depending on a phase of the cardiac cycle in patients with degenerative aortic stenosis, who underwent aortic valve replacement with different types of biological prostheses.<br /><strong>Methods.</strong> This prospective parallel controlled randomized trial study was performed at Meshalkin National Medical Research Center over a period from 2011 to 2015. The inclusion criteria were severe aortic stenosis and patients’ age older than 65 years. 114 patients were randomized 1:1 in two groups: group I included 57 patients with stentless biological prostheses, while group II (control one) consisted of 57 patients with stented xenopericardial prostheses. The average age was 71 [66; 74] and 72 [69; 77] for the first and second groups, respectively (p = 0.054). All patients underwent aortic valve replacement. The operation was performed under standard normothermic cardiopulmonary bypass. The diameter of the implanted prostheses was 25 mm [24; 26] and 23 mm [21; 23] for the first and second groups, respectively (p = 0.375). An ECG-synchronized CT study of the aortic root was carried out in the postoperative period.<br /><strong>Results.</strong> An intergroup systolic/diastolic difference in the values of the cross-sectional area of the aortic root at all levels was observed in patients with stentless bioprostheses, while the control group patients (with stented bioprostheses) had no such difference at the levels of the left ventricle output tract and the fibrous ring of the aortic valve.<br /><strong>Conclusion.</strong> A stentless design of bioprostheses retains the deformational and elastic properties of the aortic root in elderly patients with aortic valve stenosis after surgical treatment.</p><p>Received 5 December 2017. Revised 12 December 2017. Accepted 15 December 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: D.P. Demidov, D.A. Astapov, A.V. Bogachev-Prokophiev<br />Data collection and analysis: D.P. Demidov<br />Drafting the article: D.P. Demidov<br />Critical revision of the article: D.A. Astapov, A.V. Bogachev-Prokophiev<br />Final approval of the version to be published: D.A. Astapov, A.V. Bogachev-Prokophiev, S.I. Zheleznev, A.M. Karaskov</p>

scholarly journals Incidental Left Atrial Blood Cyst in a Patient Undergoing Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 42 (1) ◽  
pp. 58-60 ◽  
Author(s):  
Gregory Suero ◽  
Moneal Shah ◽  
Rachel Hughes-Doichev
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Transesophageal Echocardiography ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Valvular Stenosis

Blood cysts of the heart are benign cardiovascular tumors found incidentally in approximately 50% of infants who undergo autopsy at less than 2 months of age. These congenital cysts, frequently present on the atrioventricular valves of infants, are exceedingly rare in adults. Nonetheless, in adults, cardiac blood cysts have been found on the mitral valve, papillary muscles, right atrium, right ventricle, left ventricle, and aortic, pulmonic, and tricuspid valves. Reported complications include left ventricular outflow obstruction, occlusion of the coronary arteries, valvular stenosis or regurgitation, and embolic stroke. In high-risk patients with severe aortic stenosis, transcatheter aortic valve replacement has emerged as an alternative to surgical replacement. Transesophageal echocardiography plays a fundamental role in evaluating the feasibility of intraprocedural transcatheter aortic valve replacement, in measuring aortic annular size, in guiding placement of the prosthetic device, and in looking for possible complications. The embolic risk of rapid pacing and transcatheter aortic valve replacement in a patient with an intracardiac blood cyst is unknown, and such a case has not, to our knowledge, been reported heretofore. We present the case of a 78-year-old woman with severe aortic stenosis, in whom a blood cyst was incidentally found in the left atrium upon transesophageal echocardiography. She underwent successful transcatheter aortic valve replacement without embolic complication.

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