scholarly journals Transcatheter aortic root replacement with chimney grafts for coronary perfusion: a preliminary test in a three-dimensional-printed root model

2020 ◽  
Vol 31 (1) ◽  
pp. 121-128 ◽  
Author(s):  
Enrico Ferrari ◽  
Martin Scoglio ◽  
Giulia Piazza ◽  
Francesco Maisano ◽  
Ludwig Karl von Segesser ◽  
...  
Keyword(s):  
Aortic Root ◽  
Free Flow ◽  
Coronary Perfusion ◽  
Repair System ◽  
3 Dimensional ◽  
Root Repair ◽  
Root Model ◽  
Coronary Ostia ◽  
The Right ◽  
Aortic Root Repair

Abstract OBJECTIVES Transcatheter aortic root repair is still not available because of the technical challenge of coronary perfusion. The use of chimney grafts for coronary ostia can be an option and we tested the flow-through coronary chimney grafts deployed in a 3-dimensional-printed root model as part of a transcatheter aortic root repair system. METHODS A 3-dimensional-printed root was used to test the coronary flow after the deployment of 1 root endograft (28 mm diameter) and two 6-mm diameter 10-cm long coronary chimney grafts. Continuous coronary flows were measured in a bench test at different pressure levels (60, 80 and 100 mmHg) and compared to target coronary flows (250 ml/min at rest for the left and 150 ml/min at rest for the right coronary artery). RESULTS The computed tomography scan-based root was modified with two 5-mm diameter coronary conduits to overcome the limits of the original 3-dimensional-printed coronary ostia. The root was placed in the hydrodynamic system: adjusted coronary free flow at 60, 80 and 100 mmHg of pressure was 1913, 2200 and 2480 ml/min for left coronary and 1633, 2026 and 2366 ml/min for right coronary, respectively. After endografts deployment, mean chimney graft flow at 60, 80 and 100 mmHg of pressure was 1053 ml/min (−45%), 1306 ml/min (−41%) and 1502 ml/min (−40%) for the left coronary and 1100 ml/min (−33%), 1460 ml/min (−28%) and 1626 ml/min (−31%) for the right coronary, respectively. CONCLUSIONS In this preliminary study, chimney grafts for transcatheter aortic root repair provided 830% of target flow in the right coronary (−31% of free flow) and 414% of target flow in the left coronary (−42% of free flow) which is more than sufficient for both coronaries in real-life conditions. The potential of this approach should be further explored with specifically designed endografts.

Fate of Bicuspid Aortic Valves in Patients Undergoing Aortic Root Repair or Replacement for Aortic Root Enlargement

2006 ◽  
Vol 81 (3) ◽  
pp. 322-326 ◽  
Author(s):  
Gruschen R. Veldtman ◽  
Heidi M. Connolly ◽  
Thomas A. Orszulak ◽  
Joseph A. Dearani ◽  
Hartzell V. Schaff
Keyword(s):  
Aortic Root ◽  
Aortic Valves ◽  
Root Repair ◽  
Bicuspid Aortic Valves ◽  
Aortic Root Enlargement ◽  
Aortic Root Repair

scholarly journals Patient-tailored aortic root repair in adult marfanoid patients: Surgical considerations and outcomes

2018 ◽  
Vol 155 (1) ◽  
pp. 43-51.e1 ◽  
Author(s):  
Paul P. Urbanski ◽  
Atanas Jankulowski ◽  
Aleksandra Morka ◽  
Vadim Irimie ◽  
Xiaochun Zhan ◽  
...  
Keyword(s):  
Aortic Root ◽  
Root Repair ◽  
Aortic Root Repair

Aortic Root Repair for Thoracic Aorta False Aneurysm Following Bentall Procedure

2008 ◽  
Vol 17 (4) ◽  
pp. 334-336 ◽  
Author(s):  
Sanjay Kumar ◽  
Steve Jones ◽  
U.M. Sivananthan ◽  
J.P. McGoldrick
Keyword(s):  
Thoracic Aorta ◽  
Aortic Root ◽  
False Aneurysm ◽  
Bentall Procedure ◽  
Root Repair ◽  
Aortic Root Repair

scholarly journals Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair

2012 ◽  
Vol 143 (6) ◽  
pp. 1389-1395.e1 ◽  
Author(s):  
Takashi Kunihara ◽  
Diana Aicher ◽  
Svetlana Rodionycheva ◽  
Heinrich-Volker Groesdonk ◽  
Frank Langer ◽  
...  
Keyword(s):  
Aortic Root ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Root Repair ◽  
Aortic Root Repair

scholarly journals A case report of aortic root repair using a pericardial autograft for type A aortic dissection

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yi Chang ◽  
Hongwei Guo ◽  
Xiangyang Qian ◽  
Fang Fang
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Aortic Wall ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Intimal Flap ◽  
Root Repair ◽  
Coronary Ostia

Abstract Background Acute type A aortic dissection with a dissection flap extending into the sinus segment often involves the commissures and the coronary ostia. In most cases, the intimal flap must be retained in order to restore aortic valve competence and reconstruct the coronary ostia. Residual dissection flap has the potential risks of proximal bleeding and adverse effects on long-term durability. We established a novel technique to reconstruct the aortic root using a pericardial autograft and significantly reduce remnant dissection tissues. Case presentation A 50-year-old female was admitted to our center with acute anterior chest pain and backache lasting about 10 h. Computed tomographic (CT) scans showed type A aortic dissection, with both coronary ostia being involved. Doppler echocardiography showed moderate aortic insufficiency. The dissection intimal flap was removed to the normal aorta wall near the annulus at the noncoronary sinus, leaving a 5 mm rim of intimal flap near the commissures and coronary ostia. Using a pericardial patch as a new aortic wall to reconstruct the root while preserving the aortic adventitia to fix and strengthen the new pericardial aortic wall. Ascending aorta and total arch replacement combined with frozen elephant trunk procedure was performed at the same time. The patient got an uneventful postoperative course. Conclusion Aortic root repair with a pericardial autograft is a safe and effective technique to treat acute type A dissection involving the sinus. Using this technique, residual dissection tissues could be significantly reduced, which subsequently decreases the risk of proximal bleeding and hence increases long-term durability.

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