Technique of surgical aortic valve implantation using single interrupted annular sutures

2020 ◽  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Valves ◽  
Intraoperative Complications ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Prosthetic Heart Valves ◽  
Surgical Aortic Valve Replacement ◽  
Conduction Disturbances

The introduction of the first surgical prosthetic heart valves in the early 1960s made effective treatment of aortic valve disease possible. The goal of surgical aortic valve replacement is to replace the diseased aortic valve with a properly functioning, sufficiently large prosthesis while avoiding intraoperative complications such as conduction disturbances, coronary artery occlusion, or paravalvular leaks. Although most commonly, non-everting pledgeted mattress sutures are used to implant the prosthesis during surgical aortic valve replacement , interrupted single sutures without pledgets can be a useful alternative, especially in patients with a small tissue annulus, because they theoretically maximize the orifice available for flow. This tutorial discusses the surgical technique of surgical aortic valve replacement using interrupted single annular sutures.

scholarly journals Acute Left Main Coronary Artery Occlusion After Percutaneous Aortic Valve Replacement

2012 ◽  
Vol 59 (18) ◽  
pp. 1654 ◽  
Author(s):  
Gonzalo Barge-Caballero ◽  
Manuel López-Pérez ◽  
Alberto Bouzas-Mosquera ◽  
Ramón Fábregas-Casal ◽  
Nemesio Álvarez-García ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Main Coronary Artery ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Left Main ◽  
Percutaneous Aortic Valve Replacement

scholarly journals Durability of Transcatheter Heart Valves: Standardized Definitions and Available Data

2021 ◽  
Vol 10 (18) ◽  
pp. 4180
Author(s):  
Ines Richter ◽  
Holger Thiele ◽  
Mohamed Abdel-Wahab
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Valves ◽  
Academic Research ◽  
Surgical Aortic Valve Replacement ◽  
Factors Affecting ◽  
Transcatheter Aortic Valve ◽  
Research Consortium

Transcatheter aortic valve replacement is a well-established alternative to surgical aortic valve replacement in high-risk patients with severe symptomatic aortic stenosis. Currently, this technique is shifting towards younger patient groups with intermediate- and low-risk profile, which raises the question about long-term durability. Despite acceptable results up to 5 years, little is currently known about valve performance beyond 5 years. Since valve deterioration, thrombosis and endocarditis seem to be the main factors affecting valve durability, precise and widely accepted definitions of these parameters were stated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in 2017, followed by the Valve in Valve International Data (VIVID) group definitions in 2018 and the Valve Academic Research Consortium 3 (VARC-3) definitions in 2021. Until the introduction of these definitions, interstudy comparisons were difficult due to missing uniformity. Since the release of these recommendations, an increasing number of studies have reported their data on long-term durability using these new criteria. The aim of the present article is to discuss the current definitions on bioprosthetic valve durability, and to summarize the available data on long-term durability of transcatheter aortic valves.

Doppler Hemodynamics of CarboMedics Prosthetic Valves in Aortic Position at Rest and Exercise

1996 ◽  
Vol 4 (3) ◽  
pp. 146-151
Author(s):  
Ichiro Shimada ◽  
Hitoshi Okabayashi ◽  
Takeshi Nishina ◽  
Kenji Minatoya ◽  
Yoshiharu Soga ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Pressure Gradient ◽  
Valve Replacement ◽  
Performance Index ◽  
Heart Valves ◽  
Peak Pressure ◽  
Prosthetic Heart Valves ◽  
Pressure Gradients ◽  
Theoretical Performance

To evaluate the size adequacy of CarboMedics prosthetic heart valves, Doppler pressure gradients after aortic valve replacement were determined at rest and immediately after exercise in 83 patients, at a mean time of 18.8 days after aortic valve replacement with CarboMedics prosthetic heart valves (31 standard and 52 R-series). There were 54 males and 29 females, average age 55 years; 12 had pure aortic stenosis, 47 had aortic regurgitation, and 24 had combined lesions. Exercise significantly increased (p < 0.01) the peak velocity (from 2.50 to 2.88 m/sec), the peak pressure gradient (from 25.9 to 34.6 mm Hg), and the mean pressure gradient (from 13.9 to 18.4 mm Hg). Significant differences were observed even in patients with seemingly large valve sizes. Significant correlation (p < 0.0001) was observed between pressure gradients at rest and immediately after exercise, as well as between pressure gradients and theoretical performance index. A theoretical performance index larger than 1.0 cm2/m2 was needed to obtain a postexercise Doppler peak pressure gradient of less than 60 mm Hg early after aortic valve replacement using either the Carbomedics standard or R-series prosthetic heart valves.

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