scholarly journals Subcoronary Ross/Ross–Konno operation in children and young adults: initial single-centre experience

2020 ◽  
Vol 59 (1) ◽  
pp. 226-233 ◽  
Author(s):  
Peter Murin ◽  
Viktoria H.M Weixler ◽  
Jasmin Moulla-Zeghouane ◽  
Olga Romanchenko ◽  
Anastasia Schleiger ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Root ◽  
Somatic Growth ◽  
Left Ventricular ◽  
Mortality And Morbidity ◽  
Excellent Outcome ◽  
Ross Operation ◽  
Children And Young Adults ◽  
Konno Operation

Abstract OBJECTIVES We sought to evaluate the outcome after modified subcoronary Ross/Ross–Konno operation in children and young adults. METHODS Between January 2013 and January 2019, a total of 50 patients with median age of 6.3 years (range 0.02–36.5 years, 58% males), including 10 infants (20%), received modified subcoronary Ross/Ross–Konno operation at our institution. Survival, morbidity, reinterventions, aortic valve function and aortic root dimensions were analysed. RESULTS At a median follow-up of 31.2 months (range 14.4–51 months), there were 1 early death and 1 late death, both in the infant group. The overall survival at 5 years after the operation was 95%. Two patients needed aortic valve replacement, 11 and 15 months after their Ross operation. At 5 years, freedoms from reoperation on the autograft and on the right ventricle to pulmonary artery conduit were 94% and 97%, respectively. Freedom from aortic valve regurgitation greater than mild was 97% at 5 years. Median dimensions of the aortic root at all levels remained in normal range at last visit. Forty-four patients (95%) were in New York Heart Association class I with normal left ventricular function. CONCLUSIONS The initial experience with the subcoronary Ross/Ross–Konno operation in children and young adults showed excellent outcome. The mortality and morbidity among infants remain significant. The described technique is reproducible and might be advantageous in situations when prosthetic supporting techniques interfere with somatic growth.

Recycling of the Pulmonary Autograft During Reverse Ross Operation: From Pulmonary Valve to Neoaortic Valve and Back

2019 ◽  
Vol 10 (2) ◽  
pp. 242-244
Author(s):  
Martin Schmiady ◽  
Dominique Bettex ◽  
Michael Hübler ◽  
Martin Schweiger
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Operative Technique ◽  
Pulmonary Valve ◽  
Ross Procedure ◽  
Ross Operation ◽  
Pulmonary Autograft ◽  
Hemodynamic Profile ◽  
Children And Young Adults

The Ross operation is the operation of choice for children and young adults who require aortic valve replacement. Although the allograft does not require anticoagulation and has a superior hemodynamic profile compared to other valve substitutes, concerns regarding allograft and autograft longevity have risen in the last decade. We present a case illustrating an alternative operative technique for patients with failed Ross procedure in which the autograft is recycled in order to avoid a two-allograft replacement.

scholarly journals Aortic Valve Replacement and the Ross Operation in Children and Young Adults

2016 ◽  
Vol 67 (24) ◽  
pp. 2858-2870 ◽  
Author(s):  
Mansour T.A. Sharabiani ◽  
Dan M. Dorobantu ◽  
Alireza S. Mahani ◽  
Mark Turner ◽  
Andrew J. Peter Tometzki ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Ross Operation ◽  
Children And Young Adults

scholarly journals Left Ventricular Diastolic Function in Children and Young Adults With Congenital Aortic Valve Disease

2013 ◽  
Vol 111 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Kevin G. Friedman ◽  
Doff B. McElhinney ◽  
Jonathan Rhodes ◽  
Andrew J. Powell ◽  
Steven D. Colan ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Diastolic Function ◽  
Aortic Valve Disease ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Valve Disease ◽  
Ventricular Diastolic Function ◽  
Children And Young Adults

Replacement of the Aortic Root with a Pulmonary Autograft in Children and Young Adults with Aortic-Valve Disease

1994 ◽  
Vol 330 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Nicholas T. Kouchoukos ◽  
Victor G. Davila-Roman ◽  
Thomas L. Spray ◽  
Suzan F. Murphy ◽  
Johanna B. Perrillo
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Root ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
Pulmonary Autograft ◽  
Children And Young Adults

Effect of Body Size, Ponderosity, and Blood Pressure on Left Ventricular Growth in Children and Young Adults in the Bogalusa Heart Study

Circulation ◽  
1995 ◽  
Vol 91 (9) ◽  
pp. 2400-2406 ◽  
Author(s):  
Elaine M. Urbina ◽  
Samuel S. Gidding ◽  
Weihang Bao ◽  
Arthur S. Pickoff ◽  
Kaliope Berdusis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Body Size ◽  
Left Ventricular ◽  
Bogalusa Heart Study ◽  
Heart Study ◽  
Children And Young Adults

scholarly journals Effect of Eccentric Calcification of an Aortic Valve on the Implant Depth of a Venus-A Prosthesis During Transcatheter Aortic Valve Replacement: A Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Lanlan Li ◽  
Yang Liu ◽  
Ping Jin ◽  
Jiayou Tang ◽  
Linhe Lu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Transcatheter Aortic Valve Replacement ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Release Process ◽  
Standard Position ◽  
Transcatheter Aortic Valve

ObjectOur goal was to assess the implant depth of a Venus-A prosthesis during transcatheter aortic valve replacement (TAVR) when the areas of eccentric calcification were distributed in different sections of the aortic valve.MethodsA total of 53 patients with eccentric calcification of the aortic valve who underwent TAVR with a Venus-A prosthesis from January 2018 to November 2019 were retrospectively analyzed. The patients were divided into three groups (A, B, and C) according to the location of the eccentric calcification, which was determined by preprocedural computerized tomography angiography (CTA) images. The prosthesis release process and position were evaluated by contrast aortography during TAVR, and the differences in valve implant depths were compared among the three groups. The effects of different aortic root structures and procedural strategies on prosthesis implant depth were analyzed.ResultsEleven patients had eccentric calcification in region A; 19 patients, in region B; and 23 patients, in region C. The patients with eccentric calcification in region B had a higher risk of prosthesis migration (10.5% upward and 21.1% downward), and the position of the prosthesis after TAVR in group B was the deepest among the three groups. When eccentric calcification was located in region A or C, the prosthesis was released at the standard position with more stability, and the location of the prosthesis was less deep after TAVR (region A: 4.12 ± 3.4 mm; region B: 10.2 ± 5.3 mm; region C: 8.4 ± 4.0 mm; region A vs. region B, P = 0.0004; region C vs. region B; and P = 0.0360). In addition, the left ventricular outflow tract (LVOT) (P = 0.0213) and aortic root angulation (P = 0.0263) also had a significant effect on implant depth in the aortic root structure of the patients. The prosthesis size was 28.3 ± 2.4 in the deep implant group and 26.4 ± 2.0 in the appropriate implant group (P = 0.0068).ConclusionThe implant depth of the Venus-A prosthesis is closely related to the distribution of eccentric calcification in the aortic valve during TAVR. Surgeons should adjust the surgical strategy according to aortic root morphology to prevent prosthesis migration.

In the Loop—Left Ventricular Pressures

2011 ◽  
pp. 42-47
Author(s):  
James R. Munis
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Stroke Volume ◽  
Cardiovascular System ◽  
Aortic Root ◽  
Left Ventricular ◽  
Root Pressure ◽  
The Third

We've already looked at 2 types of pressure that affect physiology (atmospheric and hydrostatic pressure). Now let's consider the third: vascular pressures that result from mechanical events in the cardiovascular system. As you already know, cardiac output can be defined as the product of heart rate times stroke volume. Heart rate is self-explanatory. Stroke volume is determined by 3 factors—preload, afterload, and inotropy—and these determinants are in turn dependent on how the left ventricle handles pressure. In a pressure-volume loop, ‘afterload’ is represented by the pressure at the end of isovolumic contraction—just when the aortic valve opens (because the ventricular pressure is now higher than aortic root pressure). These loops not only are straightforward but are easier to construct just by thinking them through, rather than by memorization.

P6496Endovascular reconstruction from aortic valve to aortic arch by one-piece valved-fenestrated-bifurcated endografting in animal experiments

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z P Jing ◽  
J X Feng ◽  
X H Bao ◽  
T Li ◽  
Y Zhao ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Arch ◽  
Aortic Root ◽  
Animal Experiments ◽  
Proximal Part ◽  
Minimal Invasive ◽  
Left Ventricular ◽  
Technical Success Rate

Abstract Aims The possibility of endovascular reconstruction of aortic valve, sinus of Valsalva, and ascending aorta by a minimal-invasive single endograft has not been proven in vivo. Combining our own long-term experiences from transcatheter aortic valve replacement (TAVR) and Thoracic Endovascular Repair (TEVAR) for ascending and arch dissection, we designed the special endo-graft: a novel one-piece valved-fenestrated-bifurcated endografting, and tried to endovascularly reconstruct the area from Left ventricular outflow tract to aortic arch in animal experiments. Methods and results For 20 healthy adult female pigs weighed between 62.3±2.2 kilograms, we did aortic compute tomography angiography (CTA) examinations and measured morphologic parameters of aortic root. Then we accordingly customized the valved-fenestrated-bifurcated endograft. The endograft was delivered through transapical access and endovascularly reconstructed the segment from aortic valve to proximal part of aortic arch. The overall technical success rate was 95% because of one case of delivery system failure. Instant transesophageal echography (TEE) and aortic CTA confirmed ideal position of the endograft, satisfactory function of aortic valve, and the patency of coronary arteries in all subjects. During follow-up, 12 subjects were sacrificed according to the plan and seven were followed up for 8.1±3.6 months. There was one unplanned death of cardiac infection (unplanned mortality: 5.3%). Follow-up re-examinations (aortic CTA, cardiac ultrasound, and electrocardiogram) found no adverse events. Among 12 sacrificed subjects, there was no evidence of fenestrations alignment lost and no myocardial ischemia according to the pathological analysis. Conclusion The novel one-piece valved-fenestrated-bifurcated endografting might be feasible for minimal-invasive reconstruction of aortic root in animal models, thus provided a prospect to simultaneously treat pathologies involving aortic valve and aortic root in endovascular way.

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