scholarly journals Aortic valve leaflet replacement using autopericardium as an alternative approach of aortic valve stenosis treatment: literature review

2021 ◽  
Vol 37 (5) ◽  
pp. 52-60
Author(s):  
M. N. Askadinov ◽  
B. K. Kadyraliev ◽  
S. H. Lilotkhia ◽  
O. G. Musaev ◽  
V. B. Arutyunyan
Keyword(s):  
Aortic Valve ◽  
Anticoagulation Therapy ◽  
Young Patients ◽  
Long Term Results ◽  
Implantation Technique ◽  
Valve Prosthesis ◽  
Continuous Change ◽  
Mechanical Prosthesis ◽  
Aortic Valve Leaflets ◽  
Biological Prostheses

Regarding degenerative defects of the aortic valve, the main method of treatment is dissection of malformed leaflets and placement of prosthetic valve. In most cases, mechanical and biological prostheses are used. Each type of prosthesis has shortcomings related to both the implantation technique and essential medication support to keep it functioning. Patients with implanted mechanical prosthesis need lifelong anticoagulation therapy and constant monitoring of blood coagulation rates, where on the one hand there is a risk of occurring thromboembolic complications, and on the other hand haemorrhagic complications. The peculiarity of biological prostheses is a high probability of degeneration and the need for re-operation, especially in young patients, therefore the implantation of such prostheses is mainly carried out in elderly patients. Despite continuous change and modification of artificial valves, the ideal aortic valve prosthesis does not exist today. Various attempts to replace aortic valve leaflets with artificial and biological materials have not succeeded or gained great recognition. In 2007, Shigeyuki Ozaki introduced a technique to replace the aortic valve leaflets with an autopericardium treated with 0.6 % glutar aldehyde solution. Inspite of the encouraging mid-term results, this surgery has not yet become widespread among cardiac surgeons due to the complicated operating technique and lack of long-term results. Considering the research of literature, experience of different cardiosurgical centers in this field as well as our own experience, there is a need to systematize the results of Ozaki procedure, among patients with aortic valve pathology, presented in the recent publications.

scholarly journals Third Re-Do Surgery in a Young Woman with Massive Early Double-Valve Prosthesis and Thromboembolic Stroke

2021 ◽  
Vol 31 (2) ◽  
pp. 367-372
Author(s):  
Andreea-Antonia NICA ◽  
Andrea-Olivia CIOBANU ◽  
Roxana-Cristina RIMBAS ◽  
Alexandru VASILESCU ◽  
Vlad VINTILA ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Severe Disease ◽  
Anticoagulation Therapy ◽  
Valve Prosthesis ◽  
Thromboembolic Stroke ◽  
Mechanical Prosthesis ◽  
Valve Thrombosis ◽  
Valve Function ◽  
History Of ◽  
Valvular Replacement

Valvular heart disease affects more that 100 million people worldwide. Valvular replacement remains the only definite treatment for most of the patients with severe disease. Careful medical management and periodic followup of valve function is mandatory in order to prevent or diagnose prosthesis-related complications. We present a case of extensive mitral and aortic valve thrombosis and possible recurrent endocarditis in a 44-year-old woman non-adherent to anticoagulation therapy, presented with stroke. She also had a history of two mitral and aortic valvular heart replacement surgeries. Comprehensive and repeated imaging was used to evaluate and monitor the patient progression and outcome. Failure of adequate anticoagulation therapy to improve prosthesis function during hospitalization required third re-do surgery for mitral and aortic valve replacement with mechanical prosthesis.

scholarly journals Successful Use of Two Thrombolytic Drugs in Prosthetic Mitral and Aortic Valve Thrombosis

2020 ◽  
Author(s):  
Shayesteh Gheibi ◽  
Aliasghar Farsavian ◽  
Maryam Nabati ◽  
Gohar Eslami
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Anticoagulation Therapy ◽  
Mechanical Valve ◽  
Valve Prosthesis ◽  
Mechanical Prosthesis ◽  
First Line Therapy ◽  
Mitral Valve Prosthesis ◽  
Valve Thrombosis ◽  
Mobile Mass

Introduction: Prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. The significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. Although surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative. Case Description: In this case report, we describe a 46-year-old man with a history of the mitral valve and aortic valve replacement 2 years ago. In echocardiography, we detected a mobile mass on the atrial side of the mitral valve prosthesis and a fixed one on the leaflet of the mechanical aortic valve with a high gradient. To save his life, we used double thrombolytic therapy considering the patient’s hemodynamic situation and the risk of bleeding. Although a routine dose of reteplase and streptokinase was considered, we administered these two thrombolytic drugs together within 72 hours. Conclucsion: Ultimately we succeeded with this method without any significant or life-threatening adverse effects, and the patient was discharged after an optimal anticoagulation therapy.

The Ross-Konno Procedure as Reoperative Treatment in a Young Adult with Congenital Aortic Stenosis

2012 ◽  
Vol 15 (4) ◽  
pp. 182
Author(s):  
Fotios A. Mitropoulos ◽  
Meletios A. Kanakis ◽  
Sotiria C. Apostolopoulou ◽  
Spyridon Rammos ◽  
Constantine E. Anagnostopoulos
Keyword(s):  
Young Adult ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Young Patients ◽  
Uneventful Recovery ◽  
Ross Procedure ◽  
Congenital Aortic Stenosis ◽  
Biological Prostheses

<p>Mechanical and biological prostheses are valid options when aortic valve replacement is necessary. The Ross procedure is also an alternative solution, especially for young patients.</p><p>We describe the case of a young patient with congenital aortic stenosis and bicuspid aortic valve who presented with dyspnea on exertion. An open commissurotomy was performed, and within 8 months the patient developed recurrent symptoms of severe aortic stenosis. He underwent redo sternotomy and a Ross-Konno procedure with an uneventful recovery.</p>

Minimally invasive redo aortic valve replacement with a sutureless valve implant

2021 ◽  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Valve Prosthesis ◽  
Mechanical Prosthesis ◽  
Invasive Approach ◽  
Replacement Procedure ◽  
Aortic Valve Prosthesis ◽  
Sutureless Valve

Reoperations for a dysfunctional mechanical aortic valve prosthesis are usually performed with a repeat sternotomy. Reopening the chest may be associated with a heart structure tear, bleeding, excessive transfusion, and a possible unfavorable outcome. Experience performing a redo aortic valve replacement with a minimally invasive approach and avoiding lysis of the pericardial adhesions is growing. We describe a redo aortic valve replacement procedure performed because of subvalvular pannus formation in a patient with a mechanical prosthesis. A partial J-shaped hemisternotomy at the 3rd intercostal space was performed; the ascending aorta was exposed and the valve was replaced with a sutureless bioprosthesis. The video tutorial shows the surgical approach, cardiopulmonary bypass solutions, and sutureless valve deployment.

scholarly journals Long-Term Results of Aortic Valve Replacement With Mechanical Prosthesis or Carpentier-Edwards Perimount Bioprosthesis in Japanese Patients According to Age

2014 ◽  
Vol 78 (11) ◽  
pp. 2688-2695 ◽  
Author(s):  
Takahiro Nishida ◽  
Hiromichi Sonoda ◽  
Yasuhisa Oishi ◽  
Hideki Tatewaki ◽  
Yoshihisa Tanoue ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Japanese Patients ◽  
Long Term Results ◽  
Mechanical Prosthesis

Implantation technique and results using a new transapical aortic valve prosthesis - Symetis Acurate

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
J Kempfert ◽  
A Rastan ◽  
D Holzhey ◽  
M Schönburg ◽  
F Beyersdorf ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Implantation Technique ◽  
Valve Prosthesis ◽  
Aortic Valve Prosthesis

scholarly journals Fifty-one years with an aortic valve prosthesis despite suboptimal anticoagulation: half a century with the Smeloff-Cutter valve

2020 ◽  
Author(s):  
Vincenzo F Tripodi ◽  
Angelo Covino ◽  
Pasquale Fratto ◽  
Frank A Benedetto
Keyword(s):  
Aortic Valve ◽  
Anticoagulant Therapy ◽  
Unusual Case ◽  
Good Health ◽  
Valve Prosthesis ◽  
Valve Regurgitation ◽  
Mechanical Prosthesis ◽  
Aortic Valve Prosthesis ◽  
Long Time ◽  
First Time

Abstract This case report describes an unusual case of a 69-year-old man who had an aortic valve replacement with the Smeloff-Cutter aortic mechanical prosthesis for aortic valve regurgitation at the age of 18 years. Echocardiography revealed a well-suited and well-functioning mechanical prosthesis. Even though the patient did not take any anticoagulant therapy or anti-platelets agent for 12 years, he was in surprisingly good health. To the best of our knowledge, this is the first time a mechanical ‘ball-in-cage’ valve prosthesis has lasted for such a long time without complications, although the patient has not been compliant with the anticoagulant therapy for 12 consecutive years.

Results of mechanical versus tissue AVR: caution in young patients with tissue AVR

Heart ◽  
2019 ◽  
Vol 105 (Suppl 2) ◽  
pp. s34-s37
Author(s):  
Norman Paul Briffa
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Mechanical Heart Valve ◽  
Young Patients ◽  
Patient Choice ◽  
Heart Valve Disease ◽  
Valve Prosthesis ◽  
Younger Patients ◽  
Mechanical Prostheses ◽  
Aortic Valve Prosthesis

The first aortic valve prosthesis, implanted more than 50 years ago, was a mechanical prosthesis (ball-and-cage design). Over the ensuing decades, tissue prostheses and new mechanical designs were introduced to mitigate the need for anticoagulation with its associated side effects. Tissue and mechanical heart valve prostheses were compared in two head-to-head randomised control trials. Both of these confirmed that mechanical prostheses were durable but patients suffered anticoagulant-related bleeds. Patients who received a tissue prosthesis were more likely to suffer prosthetic dysfunction and require reoperation. This trend was stronger in younger patients. Since the publication of those two trials, several large retrospective studies using data from meta-analyses of published papers or registries have failed to show a survival advantage of either prostheses when implanted in the aortic position in younger patients. This equipoise has been reflected in the heart valve disease guidelines published by European and US societies. In recent years, the primacy of patient choice, the rapid increase in life expectancy of populations, the increased incidence of atrial fibrillation with requirement for anticoagulation, the advent of transcatheter techniques to treat degenerating tissue valves as well as advances in anticoagulant therapy and in new tissue and to a lesser extent mechanical prosthetic design continue to influence choice of aortic valve prosthesis in younger patients undergoing aortic valve replacement.

Perceval Sutureless Aortic Valve Prosthesis Easy, Fast, and Safe

2011 ◽  
Vol 6 (6) ◽  
pp. 378-381 ◽  
Author(s):  
Giuseppe Santarpino ◽  
Steffen Pfeiffer ◽  
Giovanni Concistrè ◽  
Theodor Fischlein
Keyword(s):  
Aortic Valve ◽  
Operation Time ◽  
Implantation Technique ◽  
Valve Prosthesis ◽  
Native Valve ◽  
Old Patients ◽  
Invasive Approach ◽  
Implantation Time ◽  
Aortic Valve Prosthesis ◽  
Group A

Objective There is an increase of old patients needing aortic valve surgery. Especially in this age group, a lot of new less-invasive strategies are proposed. Our goal was to study whether a sutureless aortic valve, which is implanted surgically after removal of the native valve, could be an alternative for a subgroup of patients. Methods The Sorin Perceval S is a biologic pericardial aortic valve assembled in a metal super elastic alloy stent and implanted in the aortic root without the need of suturing. As part of a premarketing multicenter study (Cavalier trial), 34 patients were screened for Perceval S implantation. All patients underwent cardiopulmonary bypass and mini-invasive approach (partial upper sternotomy). Results Fourteen patients were excluded due to standardized criteria. Twenty patients received a 21-mm valve (2 patients), 23-mm valve (6 patients), or 25-mm valve (12 patients). X-clamp time was 20.6 ± 7.6 minutes, and implantation time was 8.6 ± 3.1 minutes. Intra- and postoperative echocardiography showed no paravalvular leakage, low gradients (max 16.3 ± 5, mean 9.8 ± 4.2), and two patients with an intraprosthesis reflux (one patient with 1/4+, one patient with 2/4+). All patients were discharged without major in-hospital complications (intensive care unit stay 1.4 ± 0.5 days, hospital stay 7 ± 0.7 days). Conclusions The sutureless Perceval S aortic valve is hemodynamically excellent and a safe prosthesis in selected patients. Due to a simple and fast implantation technique, this valve could guarantee a shorter operation time in combination with a mini-invasive approach.

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