To the semiotics of aortic stenosis

Aortic stenosis, in particular its pure form, not combined with aortic valve insufficiency, is the rarest of extrauterine heart defects, so rare that, as Prof. S.S. Zimnitsky points out, in some authors' statistics "this defect does not appear at all". Indeed, in Schnitt's statistics, as well as in Guttmann's statistics cited by Killbs, and in Killbs' own statistics, stenosis ostii aortae is completely silent. Hirschfeider found this defect in only 3% of all his cases, and always in combination with aortic insufficiency. Gerhardt reported this defect 19 times out of 300 cases.

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Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children With Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty

The American Journal of Cardiology ◽

10.1016/j.amjcard.2015.12.034 ◽

2016 ◽

Vol 117 (6) ◽

pp. 972-979 ◽

Cited By ~ 11

Author(s):

Christopher J. Petit ◽

Kevin Gao ◽

Bryan H. Goldstein ◽

Sean M. Lang ◽

Scott E. Gillespie ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Stenosis ◽

Balloon Valvuloplasty ◽

Aortic Valve Insufficiency ◽

Congenital Aortic Stenosis ◽

Residual Stenosis ◽

Morphologic Characteristics ◽

Valve Insufficiency

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Management of aortic insufficiency in patients with left ventricular assist device ̶ a retrospective analysis

The VAD Journal ◽

10.14434/vad.v4i0.27987 ◽

2018 ◽

Author(s):

Hartmuth B. Bittner

Keyword(s):

Aortic Valve ◽

Left Ventricular Assist Device ◽

De Novo ◽

Aortic Insufficiency ◽

Left Ventricular ◽

Aortic Valve Insufficiency ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

Valve Insufficiency

Background Aortic insufficiency is increasingly recognized as a complication of left ventricular assist device (LVAD) support and may lead to clinical decompensation requiring correction. This article describes experiences in managing patients presenting with concomitant aortic insufficiency and with de novo aortic insufficiency following left ventricular assist device implantations. Methods All patients undergoing LVAD implantation between 2012 and 2014 were included in this retrospective analysis if aortic valve insufficiency was present on implantation or newly developed (de novo) after implantation. Moderate to severe aortic valve insufficiency was corrected at implantation. Results The data of 39 patients were included. At the time of LVAD implantation, moderate to severe aortic valve insufficiency was present in 3 patients and was corrected by bioprosthetic valve replacement (2 patients) and by bioprosthetic valve replacement associated with ascending aorta with hemi arch replacement with a graft due to ascending aortic aneurysm (one patient). Four patients developed moderate to severe aortic insufficiency after LVAD surgery. Treatment with conservative medical management was successful in 3 patients. One patient underwent transcatheter aortic valve occlusion using an Amplatzer closure device after failure of medical management. Conclusions Concomitant aortic valve replacement with LVAD implantation is a safe and viable option in managing aortic valve insufficiency. De novo aortic insufficiency may lead to recurrent heart failure and presents a clinical treatment challenge following successful LVAD support; the most appropriate and effective treatment option awaits definition.

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Approaches to aortic valve preservation in patients with aortic root an-eurysms and aortic insufﬁciency: the David procedure

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2009-15-2-142-145 ◽

2009 ◽

Vol 15 (2) ◽

pp. 142-145

Author(s):

V. Uspenskiy ◽

I. V. Sukhova ◽

M. L. Gordeev

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Aortic Insufficiency ◽

Aortic Valve Insufficiency ◽

Short Term ◽

Aortic Root Aneurysm ◽

Valve Insufficiency ◽

The Common ◽

Valve Sparing ◽

Aortic Valve Reimplantation

Background. Aortic valve-sparing operations are one of the relatively new approaches for treatment of patients with aortic root aneurysm and aortic valve insufficiency, but nowadays the common treatment strategy is absent. Methods. We studied the short-term results of David I valve-sparing operations in 19 patients with aortic root aneurysms and aortic insufficiency. Results. There were no lethal cases observed. 3 patients had mild aortic regurgitation, the majority of patients had no or trace aortic insufficiency. The significant decrease of left ventricle sizes was shown. Conclusions. The David I technique of aortic valve reimplantation seems to be optimal in patients with aortic root aneurysm, aortic insufficiency and normal aortic cusps.

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Freestyle Xenograft Implantation Technique for Reducing Aortic Insufficiency

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230201000426 ◽

2002 ◽

Vol 10 (4) ◽

pp. 369-371

Author(s):

Ahmed A Arifi ◽

Song Wan ◽

Samer Nashef ◽

Calvin SH Ng ◽

Innes YP Wan ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Aortic Insufficiency ◽

Implantation Technique ◽

Aortic Valve Insufficiency ◽

Valve Insufficiency

The Freestyle aortic xenograft has been shown to be safe and effective for aortic valve replacement. However, implantation is often complicated by aortic valve insufficiency, which could lead to premature valve failure. We describe an implantation technique that can potentially prevent aortic insufficiency.

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Templates of flat pericardial patterns for precise aortic cusp extension

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492318780482 ◽

2018 ◽

Vol 26 (5) ◽

pp. 361-366 ◽

Cited By ~ 1

Author(s):

Mohammad Bashar Izzat ◽

Mohammad Mouath Alkhayat

Keyword(s):

Aortic Valve ◽

Aortic Insufficiency ◽

Pericardial Patch ◽

Aortic Valve Insufficiency ◽

Aortic Cusp ◽

Bovine Pericardial Patch ◽

Natural Geometry ◽

Intraoperative Transesophageal Echocardiography ◽

Valve Insufficiency

Background Aortic cusp extension is a subjective and operator-dependent technique. In order to facilitate surgical correction of aortic cusp retraction and reestablishment of adequate cusp coaptation, we sought to develop new templates that can be used to cut flat pericardial sheets into precise cusp extension patches. Methods Each template was designed as a two-dimensional unwrap of the natural geometry of a complete aortic cusp, and a series of templates were made available to correspond with all potential aortic cusp sizes. Based on these templates, aortic cusp extension was performed in 2 patients (aged 54 and 43 years) with significant retraction of the noncoronary aortic cusps and severe aortic valve insufficiency. In each patient, extension of the retracted native noncoronary cusp was undertaken using a bovine pericardial patch that matched the size of adjacent nondiseased native aortic cusps. Results Achieving geometrically perfect aortic cusp extensions was uncomplicated, and intraoperative transesophageal echocardiography confirmed satisfactory aortic valve repairs (aortic insufficiency < 1+ and low transvalvular gradients). Early follow-up transthoracic echocardiography confirmed that all valve cusps met at similar heights in the aortic root, and that their excursions were virtually identical. Conclusions The newly designed templates can be used to cut flat pericardial sheets into exact cusp extension patches, and initial clinical experience indicates that they are useful in performing precise aortic cusp extension procedures and restoring adequate aortic valve competence.

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