scholarly journals Outcome of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement

2021 ◽  
Vol 13 (3) ◽  
pp. 1531-1542
Author(s):  
Yaojun Dun ◽  
Yi Shi ◽  
Hongwei Guo ◽  
Yanxiang Liu ◽  
Xiangyang Qian ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Sutureless Prosthesis Implantation and Ascending Aorta Replacement through a Ministernotomy Approach

2018 ◽  
Vol 13 (3) ◽  
pp. 239-241
Author(s):  
Antonio Lio ◽  
Matteo Ferrarini ◽  
Antonio Miceli ◽  
Mattia Glauber
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Proportion ◽  
Ascending Aorta ◽  
Prosthesis Implantation ◽  
Sutureless Valve ◽  
Aorta Replacement ◽  
Valve Implantation ◽  
Ascending Aorta Replacement

A significant proportion of patients undergoing aortic valve replacement have a dilated ascending aorta; presence of an ascending aorta aneurysm is viewed as a contraindication for sutureless valve implantation for the potential risk of prosthesis dislodgment. We describe our technique of sutureless prosthesis implantation and concomitant ascending aorta replacement through an upper ministernotomy. Seven patients underwent aortic valve replacement with a sutureless prosthesis and concomitant ascending aorta replacement between November 2014 and October 2016. A J-shaped upper ministernotomy was performed in all patients. Diameter of vascular graft for the replacement of the dilated ascending aorta was chosen according to the size of the selected prosthesis, to recreate a ratio between diameters of the new sinotubular junction and the aortic annulus that should be less than 1.3. Postoperatively. no patient died in hospital. No paravalvular leakage or prosthesis dislodgment was reported. Mean ± SD cardiopulmonary bypass and cross-clamp times were 142 ± 52 minutes and 85 ± 18 minutes, respectively. In patients undergoing aortic valve replacement and ascending aorta replacement, sutureless valve implantation is a safe and reproducible procedure associated with good postoperative results.

Open hemiarch versus clamped ascending aorta replacement for aortopathy during initial bicuspid aortic valve replacement

2021 ◽  
Vol 161 (1) ◽  
pp. 12-20.e2 ◽  
Author(s):  
Kevin L. Greason ◽  
Juan A. Crestanello ◽  
Katherine S. King ◽  
Gabor Bagameri ◽  
Sertac M. Cicek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

scholarly journals The Role of ECG-Gated CT in Patients with Bicuspid Aortic Valve Replacement: New Perspectives in Short- and Long-Term Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Massimiliano Sperandio ◽  
Chiara Arganini ◽  
Alessio Bindi ◽  
Armando Fusco ◽  
Carlo Olevano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Root Diameter ◽  
Ascending Aorta ◽  
Short And Long Term ◽  
The Stability

The aim of our study was to compare the results of the TTE (transthoracic echocardiography) with the results obtained by the ECG-gated 64 slices CT during the followup of patients with bicuspid aortic valve (BAV), after aortic valve replacement; in particular we evaluated the aortic root and the ascending aorta looking for a new algorithm in the followup of these patients. From January 1999 to December 2009 our attention was focused on 67 patients with isolated surgical substitution of aortic valve; after dismissal they were strictly observed. During the period between May and September 2010, these patients underwent their last evaluation, and clinical exams, ECG, TTE, and an ECG-gated-MDCT were performed. At followup TTE results showed an aortic root of 36.7±4 mm and an ascending aorta of 39.6±4.8 mm. ECG- gated CT showed an aortic root of 37.9±5.5 mm and an ascending aorta of 43.1±5.2. The comparison between preoperative and postoperative TTE shows a significant long-term dilatation of the ascending aorta while the aortic root diameter seems to be stable. ECG-gated CT confirms the stability of the aortic root diameter (38.2±5.3 mm versus 37.9±5.5  mm; <0.0001) and the increasing diameter value of the ascending aorta (40.2±3.9 mm versus 43.1±5.2 mm; P=0.0156). Due to the different findings between CT and TTE studies, ECG-gated CT should no longer be considered as a complementary exam in the followup of patients with BAV, but as a fundamental role since it is a real necessity.

scholarly journals Early and mid-term outcomes of modified aortic root repair for acute stanford type A aortic dissection

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L C Wang ◽  
Y X Liu ◽  
Y J Dun ◽  
X G Sun
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
False Lumen ◽  
Ascending Aorta ◽  
Aortic Sinus ◽  
Root Repair ◽  
Aorta Replacement ◽  
Aortic Root Repair ◽  
Ascending Aorta Replacement

Abstract Background Acute Stanford type A aortic dissection (ATAAD) is the most common catastrophic aortic event. Most ATAAD involves the aortic root which has many important anatomical structures such as aortic valve, so the proper treatment of dissected root can ensure a good prognosis for patients. However, there is still no consensus on root management strategies for ATAAD patients with aortic root involvement. Purpose This clinical study aimed to evaluate the therapeutic effect of modified aortic root repair in ATAAD. Methods From September 2017 to September 2020, Participants with root involvement of ATAAD were recruited who underwent modified aortic root repair as well as some additional procedure such as aortic valve junction suspension plasty based on the aortic sinus tear extent. During this novel procedure, the proximal anastomosis plane was at the level of the sinu-tubular junction and the false lumen below it was retained. We collected and analyzed the perioperative clinical data and follow-up imaging data of patients, and further evaluated the early and mid-term efficacy of this surgical approach. Results A total of 79 patients were enrolled, including 59 males and 20 females, the age was (52.4±11.3) years old (28–73 years), the diameter of aortic sinus was (38.6±4.1) mm, and the diameter of sinu-tubular junction was (41.8±4.8) mm. In this group, 75 patients (94.9%) received ascending aorta replacement, total arch replacement and frozen elephant trunk, 2 patients (2.5%) received ascending aorta replacement and hybrid total arch replacement, 2 patients (2.5%) received ascending aorta replacement and partial arch replacement. Cardiopulmonary bypass time was (197.2±58.6) min (118–455 min), blocking time was (132.6±38.9) min (73–323 min), circulatory arrest time was (10.3±7.0) min (0–27 min). There was no perioperative death, no paraplegia, one secondary thoracotomy, five renal failures needing hemodialysis treatment and two cerebral infarctions. Before patients discharged, aortic CTA showed that the residual false lumen in the sinus disappeared. And the diameter of the aortic sinus was (35.5±3.1) mm, the diameter of the junction of the aortic sinus was (30.0±3.0) mm. The patients were followed up for (18±12) months (3–35 months). There was one patient died during follow-up and no further surgical intervention at the root of the aorta. Follow-up aortic CTA showed no residual or new dissection in the aortic sinus and no significant difference in the diameters of aortic sinu-tubular junction (P=0.122) or aortic sinus (P=0.37) between postoperative period and follow-up period. Echocardiography showed that the structure and function of the aortic valve were normal. Conclusions The modified aortic root repair for ATAAD is relatively simple, easy to learn and safe in perioperative period. Early and mid-term follow-up image examination showed that the structure of aortic sinus returned to normal. The long-term clinical effect requires close attention. FUNDunding Acknowledgement Type of funding sources: None. Modified aortic root repair procedure Aortic root diameter change under CTA

scholarly journals Cirugía de preservación valvular como alternativa en enfermedad de la raíz aórtica. Resultados alejados

2021 ◽  
Vol 89 (2) ◽  
pp. 115-123
Author(s):  
Fernando Piccinini ◽  
Adriana Aranda ◽  
Juan Mariano Vrancic ◽  
Mariano Camporrotondo ◽  
Juan Carlos Espinoza ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Bleeding Events ◽  
Actuarial Survival ◽  
Aorta Replacement ◽  
Valve Sparing ◽  
Hospital Morbidity ◽  
Aortic Root Disease

Background: Since 1968, ascending aorta replacement with a valved conduit has been the standard practice for aortic root aneurysm. By the end of the 20th century, aortic valve sparing operation emerged and evolved as an alternative to aortic valve replacement. Objective: The aim of this study was to report our experience with aortic valve sparing technique and its long -term outcomes. Methods: A total of 116 consecutive cases with criteria of repairability operated on between 2005 and 2019 were analyzed. Preopera- tive transesophageal echocardiography (TEE) and computed tomography angiography (CTA) were used in combination to determine the aortic phenotype based on a previous anatomical and functional classification. Perioperative control was performed and conver- sion to aortic valve replacement was left to the discretion of the attending surgeon. Intraoperative variables, in-hospital morbidity and mortality, freedom from significant aortic regurgitation (AR) and reoperation in the clinical and echocardiographic follow-up were reported. Results: Mean age was 56±15.6 years and 73% were men; 59% were asymptomatic, and the reason for the intervention was the aortic diameter (52±11.7 mm) or progression of AR. After the procedure, 4% of the cases presented mild or trivial AR and 2 patients required conversion to aortic valve replacement (1.7%). In hospital mortality was 0.9%. Actuarial survival was 88% at 10 years, and 79% were free from significant (moderate/severe) AR. Five cases underwent reoperation after a mean interval of 9.1 years and free- dom from reoperation at 10 years was 90%. There were no major thromboembolic or bleeding events. Conclusion: Aortic valve sparing technique in the setting of aortic root disease is a feasible and safe option, and stable over time

scholarly journals J-Mart: aortic valve replacement with Florida sleeve aortic root reconstruction

2020 ◽  
Vol 58 (6) ◽  
pp. 1304-1305
Author(s):  
Eric I Jeng ◽  
Tomas D Martin
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Aortic Root Aneurysm ◽  
Aortic Pathology

Abstract We highlight a technique combining an aortic valve replacement with the Florida sleeve repair. The patient is a 68-year-old man who had a 48-mm aortic root aneurysm and a 57-mm ascending aorta, presenting with symptomatic tri-leaflet severe aortic valve stenosis. He underwent a hemiarch, aortic valve replacement and Florida sleeve aortic root reconstruction. The patient recovered uneventfully and is now, at over 1 year postoperation, without evidence of recurrent aortic pathology.

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