scholarly journals History of the use of autologous materials in aortic valve surgery

2021 ◽  
Vol 25 (3) ◽  
pp. 106
Author(s):  
R. N. Komarov ◽  
A. O. Simonyan ◽  
I. A. Borisov ◽  
V. V. Dalinin ◽  
A. M. Ismailbaev ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Heart Valves ◽  
Surgical Techniques ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Short Service Life ◽  
Wide Range ◽  
Valve Reconstruction ◽  
History Of

<p>Various types of autologous materials are used in heart valve surgery, particularly the aortic valve, and this article describes their historical development. The evolution of the use of various autogenous tissues, such as the aortic wall, fascia lata of the thigh, pericardium and others is described and discussed in detail. This paper presents the results of experimental and clinical publications devoted to the surgical techniques and the outcomes of heart valve reconstruction using such materials. The negative aspects of the use of a wide range of autografts are discussed, including the short service life and low strength, which led to declining interest in this group of reconstructive interventions. The method for treating the autopericardium with glutaraldehyde, proposed in 1986 by C.S. Love, J.W. Love and colleagues, raised the use of autologous materials in the reconstruction of heart valves to a new level, allowing surgeons to strengthen the autopericardial flaps and increase resistance to hemodynamic stress. Many surgeons, their interest in such treatment methods increased by this discovery, then reported their observations and further developed ways of using the treated autopericardium in aortic valve surgery. Particularly, the method of neocuspidisation of the aortic valve, introduced into wide practice by M.G. Duran and S. Ozaki, has become the quintessential reconstructive valve surgery involving the use of autologous materials.</p><p>Received 14 March 2021. Revised 26 April 2021. Accepted 27 April 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors</strong><br />Conception and study design: A.O. Simonyan, A.M. Ismailbaev<br />Drafting the article: A.O. Simonyan, A.M. Ismailbaev, N.O. Kurasov, M.I. Tcheglov<br />Critical revision of the article: R.N. Komarov, V.V. Dalinin, I.A. Borisov<br />Final approval of the version to be published: R.N. Komarov, A.O. Simonyan, I.A. Borisov, V.V. Dalinin, A.M. Ismailbaev, N.O. Kurasov, M.I. Tcheglov</p>

scholarly journals Aortic root and aortic valve surgery: History and modernity

2019 ◽  
Vol 23 (4) ◽  
pp. 9
Author(s):  
R. N. Komarov ◽  
A. I. Katkov ◽  
D. P. Puzenko ◽  
S. N. Odinokova ◽  
V. N. Nikolenko
Keyword(s):  
Aortic Valve ◽  
Conflict Of Interest ◽  
Aortic Root ◽  
Cardiovascular Surgery ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Reconstructive Procedures ◽  
Plastic Materials ◽  
Wide Range ◽  
History Of

<p>Heart valve surgery, including aortic valve surgery, began to develop in the first half of the 20th century with the advancement of reconstructive procedures. Thereafter, the progress of science and technology led to the development of mechanical and biological prostheses, homografts and plastic materials, which continue to improve and transform. This review focuses on the historical aspects of the development of aortic root and aortic valve surgery, mentions the initial interventions and presents the contributions of Soviet and Russian surgeons to global surgery. The article will be interesting to cardiovascular surgery specialists as well as a wide range of readers who intend to learn more regarding the history of medicine and cardiovascular surgery.</p><p>Received 8 November 2019. Revised 10 December 2019. Accepted 12 December 2019.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Abstract 12048: Minimally Invasive Access for Aortic Valve Surgery in Octogenarians: Is it Still Justified in the Days of TAVI ?

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Udo Boeken ◽  
Sudharson Rajah ◽  
Jan Philipp Minol ◽  
Payam Akhyari ◽  
Artur Lichtenberg
Keyword(s):  
Aortic Valve ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Surgical Techniques ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Partial Sternotomy ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Minimally Invasive Access

Introduction: Increasing life expectancy in the western world and improvements in surgical techniques and postoperative care have resulted in a significant number of patients aged over 80 undergoing cardiac operations. At times of transapical and transfemoral AVR we aimed to evaluate the feasibility of partial sternotomy for patients over 80 years of age and to compare these results with a historical group of octogenarians who underwent aortic valve surgery via full sternotomy in our department between 1998 and 2006. Methods: 72 of the 275 patients (26.2 %) who underwent aortic valve replacement (AVR) after partial sternotomy between 8/2009 and 05/2013 were octogenarians. Mean age was 83.1 ± 3.9 years (group ps). We compared this group with 165 patients (mean age 81.6 ± 3.1 years) who underwent AVR via full sternotomy between 1998 and 2006 (group fs). Results: ICU- and hospital stay were significantly reduced in patients with partial sternotomy (ps: 28 ± 9 hours, 12.8 ± 4.7 days vs. fs: 59 ± 15 h, 14.7 ± 3.5 d, p<0.05). We found a higher in-hospital mortality in group fs, but without significance (4.2 vs. 2.8 % in ps). Duration of operation, of extracorporeal circulation, and of aortic cross-clamping was tendentially prolonged in patients with partial sternotomy (p>0.05). Necessity for re-operation due to bleeding was comparable in both groups (ps: 2.8 % vs. fs: 3.0 %). The incidence of postoperative complications did not differ significantly between both groups: neurological complications (ps: 2.8 vs. fs: 3.0 %), sternal wound infections (2.8 % vs. 2.4 %) and postoperative LCOS (4.2 % vs. 5.5 %). Conclusions: We could prove the feasibility of ministernotomy for aortic valve surgery for patients over 80 years of age. Despite a tendentially prolonged duration of surgery compared to procedures via full sternotomy, we found a comparable morbidity and a reduced mortality after partial sternotomy. From an economic perspective, the reduction of intensive care unit- and hospital stay after minimally invasive access was the most interesting finding. Moreover, our results after minimally invasive AVR have to be considered carefully when selecting patients for a conventional or for a TAVI procedure.

Trace Element Changes in Sclerotic Heart Valves from Patients Undergoing Aortic Valve Surgery

2002 ◽  
Vol 88 (1) ◽  
pp. 09-24 ◽  
Author(s):  
Christina Nyström-Rosander ◽  
Ulf Lindh ◽  
Stefan Thelin ◽  
Olle Lindquist ◽  
Göran Friman ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Trace Element ◽  
Heart Valves ◽  
Valve Surgery ◽  
Aortic Valve Surgery

scholarly journals Spontaneous regression of severe aortic stenosis after massive embolization in a patient with antiphospholipid syndrome

2019 ◽  
Vol 25 (1) ◽  
pp. 4-8
Author(s):  
Ali Youssef ◽  
Mustafa Alrefae ◽  
Sayed Abouelsoud
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Antiphospholipid Syndrome ◽  
Severe Aortic Stenosis ◽  
Valve Surgery ◽  
Lower Limbs ◽  
Acute Ischemia ◽  
Primary Antiphospholipid Syndrome ◽  
Aortic Valve Surgery ◽  
History Of

Summary We present a case of probably unreported aortic stenosis evolution in a patient with primary antiphospholipid syndrome (APS). A female patient, 54 years old, with a history of recurrent deep venous thrombosis, an episode of pulmonary embolism and was positive for APS antibodies. She was kept on warfarin and aspirin. The patient was admitted with acute pulmonary edema and severe aortic stenosis. While preparing for aortic valve surgery, the patient developed acute stroke, and a week later developed concurrent acute ischemia of both lower limbs. Emergency surgery salvaged the lower limbs and follow up transthoracic echocardiography showed marked regression of the thickening of the aortic valve leaflets, only mild aortic stenosis and moderate aortic regurgitation. Aortic valve surgery was cancelled, and the patient was kept on warfarin and aspirin. Conclusion Development of severe aortic stenosis is uncommon in primary APS, and this scenario of spontaneous improvement from a severe to a mild aortic stenosis, is probably unreported before.

scholarly journals Clinical Experience of Aortic Valve Surgery in Patients With Aortitis Disease

2019 ◽  
Vol 22 (5) ◽  
pp. E366-E371
Author(s):  
Yunxing Xue ◽  
Jun Pan ◽  
Qing Zhou ◽  
Qiang Wang ◽  
Hailong Cao ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Surgical Techniques ◽  
Group Versus ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Left Ventricular Ejection ◽  
Paravalvular Leak ◽  
Aortic Valve Surgery ◽  
Ventricular Ejection Fraction ◽  
Bentall Procedure

Objective: To investigate single center’s clinical experiences of aortic valve surgery for aortitis patients. Methods: From January 2010 to December 2018, 15 patients with aortitis disease were treated in our center. Among them, there were 7 males and 8 females with an average age of 48.5 ± 13.9 (29-76) years. Six patients were diagnosed as giant cell arteritis, 2 as Takayasu arteritis (Arteritis Group, N = 8) and 7 as Behcet's disease (BD Group, N = 7). Aortic valve surgery includes valvuloplasty, valve replacement, and root replacement (Bentall procedure). Results: There were 15 cases with 19 operations, 8 cases in the Arteritis Group received 8 operations while 7 cases in the BD Group received 11 operations, including 4 redo operations. Preoperative patients’ aortic valve regurgitation degree, diameter of ascending aorta and left ventricular ejection fraction were similar between the two groups. The type of aortic valve surgery also was no different. Cardiopulmonary bypass time of the BD Group seemed longer than the Arteritis Group but no different, the same as clamp time. Mechanical ventilation time is longer in the BD Group. The morbidity and mortality were similar, but the BD Group had significantly higher incidence of redo operations because of postoperative paravalvular leak or valve insufficiency (Arteritis Group versus BD Group, 0% versus 57.1%, P = .026). Conclusions: Clinical diagnosis and management of aortic valve patients with arteritis require comprehensive considerations. For aortitis patients with aortic valve surgery, special surgical techniques can be used to reduce the risk of prosthetic valve detachment.

Aortic Valve Surgery

2019 ◽  
pp. 23-28
Author(s):  
Heather Reed ◽  
Stefan Lombaard ◽  
Samantha Arzillo
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Postoperative Assessment ◽  
Class 1 ◽  
History Of ◽  
Perioperative Transesophageal Echocardiography

Aortic valve stenosis is the most common primary valvular disease today. The natural history of aortic valve stenosis is most commonly described as a long latent period without symptoms as the disease progresses from mild to severe, followed by a shorter period with symptoms; ultimately, death will result if the stenosis is left untreated. Today, severe aortic stenosis is a class 1 indication for surgery. Classic symptoms include dyspnea, syncope, and angina. Diagnostic options include echocardiography, cardiac catheterization, computed tomography, and magnetic resonance imaging. Perioperative transesophageal echocardiography is necessary for preoperative and postoperative assessment of the patient who has severe aortic stenosis.

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