Long-Term Single-Center Experience in Aortic Root Surgery: Aortic Valve-Sparing Surgery versus Bentall Procedure

2020 ◽  
Author(s):  
J. Petersen ◽  
D. Gaekel ◽  
E. Girdauskas ◽  
H. Reichenspurner ◽  
C. Detter
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Single Center ◽  
Single Center Experience ◽  
Bentall Procedure ◽  
Aortic Root Surgery ◽  
Valve Sparing

Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

2020 ◽  
Vol 11 (5) ◽  
pp. 611-618
Author(s):  
Maria Rodriguez ◽  
Anahita Malvea ◽  
Dayre McNally ◽  
Vid Bijelic ◽  
Ming Guo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Aortic Root Surgery ◽  
Valve Sparing ◽  
One Year

Background: Pediatric aortic root dilatation is a life-threatening condition that lacks guidelines for surgical management. We aimed to analyze the data on aortic valve interventions during root surgery to guide decision-making. Methods: A search was performed of MEDLINE, Embase, CENTRAL, ClinicalTrials.gov , and WHO ICTRP. Citations were screened in duplicate and independently to identify randomized controlled trials, cohorts, and case series involving populations aged 0 to 18 years, who received valve-sparing and valve-replacing aortic root surgeries between 1999 and 2019. Outcomes considered included mortality (perioperative, one year, five year), reintervention rates. Results: After duplicate removal, 689 citations were screened through abstract and full text review, identifying five eligible studies. All five were observational studies evaluating valve-sparing procedures. There were 81 patients with a mean study age range of 9.9 to 13.9 years. Both reimplantation (74%) and remodeling (26%) subtypes were done. Range of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality reported until the one-year follow-up period. The long-term mortality rate was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13). Conclusions: There is limited experience on aortic valve intervention during aortic root surgery in children. Single-arm studies on valve-sparing surgeries show excellent survival up to one year. Mortality and reintervention rates increase in the longer term. The small sample size and lack of controlled studies do not allow for direct comparisons between procedure types.

scholarly journals Long Term Results of Valve Sparing Aortic Root Replacement; A Single Center Experience

2013 ◽  
Vol 62 (18) ◽  
pp. C100
Author(s):  
Şahin Şenay ◽  
Ahmet Ümit Güllü ◽  
Aleks Değirmencioğlu ◽  
Muharrem Koçyiğit ◽  
Eyüp Murat Ökten ◽  
...  
Keyword(s):  
Aortic Root ◽  
Aortic Root Replacement ◽  
Long Term Results ◽  
Single Center ◽  
Single Center Experience ◽  
Valve Sparing

Comparing outcomes between valve-sparing root replacement and the Bentall procedure in proximal aortic aneurysms: systematic review and meta-analysis

2019 ◽  
Vol 29 (6) ◽  
pp. 911-922 ◽  
Author(s):  
Mohammad Yousuf Salmasi ◽  
Iakovos Theodoulou ◽  
Priyanka Iyer ◽  
Mohaimen Al-Zubaidy ◽  
Danial Naqvi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Meta Analysis ◽  
Aortic Aneurysms ◽  
Bentall Procedure ◽  
Significant Difference ◽  
Valve Function ◽  
Short And Long Term ◽  
Valve Sparing

AbstractIn aortic root aneurysms, the challenge of a valve-sparing aortic root replacement (VSRR) procedure is to ensure durable aortic valve function without reintervention. Although the Bentall procedure defers the durability of valve function to the prosthesis, short- and long-term complications tend to be higher. The aim of this study was to compare the outcomes of VSRR and Bentall procedures in patients with aortic root aneurysms. A systematic literature review was conducted using PubMed regarding the outcomes of the Bentall procedure compared with those of VSRR from the inception of the 2 procedures until July 2018. Studies with short- and long-term comparative data were included. An initial search yielded 9517 titles. Thirty-four studies were finally included for meta-analysis (all retrospective, non-randomized), comprising 7313 patients (2944 valve-sparing and 4369 Bentall procedures) with no evidence of publication bias. Operative mortality was found to be significantly lower in the VSRR group [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.37–0.70; P < 0.001] despite overall higher cardiopulmonary bypass and aortic cross-clamp times. The 5-year survival rate was also more favourable in the VSRR group (OR 1.93 95% CI 1.15–3.23; P < 0.05). Significantly lower rates of cerebral thromboembolism (OR 0.668, 95% CI 0.477–0.935; P = 0.019) and heart block (OR 0.386, 95% CI 0.195–0.767; P = 0.007) were also found after VSRR. There was no significant difference in rates of reoperation between the groups at long-term follow-up (OR 1.32, 95% CI 0.75–2.33; P = 0.336). Meta-regression of patient and operative covariates yielded no influence on the main outcomes (P > 0.05). These findings suggest that VSRR is an appropriate and potentially better treatment option for a root aneurysm when the aortic valve is repairable.

Long-Term Durability and Valve Integrity of Aortic Valve Bioprostheses: Single-Center Experience with Patients under 50 Years of Age

2020 ◽  
Author(s):  
E. Polat ◽  
C. Müller ◽  
L. Sinani ◽  
P. Neumann-Schniedewind ◽  
S. Peterss ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Single Center ◽  
Single Center Experience

The Skirt and Collar of The Valsalva Graft: One Dress Fits All

2021 ◽  
Author(s):  
Raffaele Scaffa ◽  
Luca Weltert ◽  
Andrea Salica ◽  
Ruggero De Paulis
Keyword(s):  
Aortic Root ◽  
Complication Rates ◽  
Valve Prosthesis ◽  
Bentall Procedure ◽  
Aortic Root Surgery ◽  
Nominal Size ◽  
Mechanical Prostheses ◽  
Valved Conduit ◽  
Valve Sparing ◽  
Graft Diameter

In the original pre-formed Valsalva graft, the skirt is the defining feature. It is a self-expanding portion, obtained by 90° rotation of the Dacron fabric corrugation with respect to the rest of the graft. Due to this manufacturing feature, the skirt length is equal to the graft diameter and, once pressurized, it expands by 25-30% (up to 10 mm) from the nominal size. Proximal to this bulged portion, a small collar completes the prosthesis. By virtue of this anatomical design, the Valsalva graft is recommended for most aortic root surgeries including valve-sparing and Bentall procedures. The skirt, by recreating the pseudo-sinuses, represents the key feature of the graft when used for aortic valve-sparing procedures (remodeling and reimplantation). However, in the Bentall procedure, the graft collar is an important feature because it is useful to attach the Valsalva graft to the valve prosthesis sewing ring when making a valved conduit. Moreover, once the graft is pressurized, the whole volume of the skirt better accommodates the struts and the leaflets of biological and mechanical prostheses. Furthermore, the expanded skirt reduces the distance and the tension on the coronary button anastomosis, increasing safety and possibly reducing complication rates. This review demonstrates the versatility of the Valsalva graft in various scenarios of aortic root surgery, with special emphasis on different uses of the skirt and the collar.

Sign in / Sign up

Export Citation Format

Share Document