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Tissue Adhesives
Published in Chih-Chang Chu, J. Anthony von Fraunhofer, Howard P. Greisler, Wound Closure Biomaterials and Devices, 2018
Seguin et al. reported aortic valve repair with fibrin glues for type A acute aortic dissection.10 The repair is now generally done by resuspending the aortic valve using different types of suturing technique, usually passing through the aortic wall, which would cause bleeding at the suture sites. Seguin et al. suggested, instead, simply injecting fibrin glues between the two dissected layers of the aortic annulus, which achieves resuspension of the aortic valve and reinforces the proximal stump without the need for any sutures. To evaluate the efficacy of this simple technique, 15 cases of patients who underwent operative intervention for the treatment of type A aortic dissection associated with acute aortic insufficiency were reviewed. The mean follow-up time was 2.3 years. The computed tomography study in all patients showed closure of the dissecting process on the proximal ascending aorta.
Augmented and Virtual Visualization for Image-Guided Cardiac Therapeutics
Published in Terry M. Peters, Cristian A. Linte, Ziv Yaniv, Jacqueline Williams, Mixed and Augmented Reality in Medicine, 2018
Cristian A. Linte, Terry M. Peters, Michael S. Sacks
Just as many patients are judged as high-risk for open-heart aortic valve repair/replacement, those with functional or degenerative MV disease also may be unable to receive standard of care (on-pump, open-heart surgery) treatment. While MV replacement/implantation devices are widely under development, current options for high-risk patients are limited to MV repair techniques, such as the trans-femoral MitraClip (Abbot Vascular Inc.) and the LV apical access NeoChord (NeoChord Inc.).
A human pericardium biopolymeric scaffold for autologous heart valve tissue engineering: cellular and extracellular matrix structure and biomechanical properties in comparison with a normal aortic heart valve
Published in Journal of Biomaterials Science, Polymer Edition, 2018
Frantisek Straka, David Schornik, Jaroslav Masin, Elena Filova, Tomas Mirejovsky, Zuzana Burdikova, Zdenek Svindrych, Hynek Chlup, Lukas Horny, Matej Daniel, Jiri Machac, Jelena Skibová, Jan Pirk, Lucie Bacakova
The current understanding of NAV geometry provides a good model design, and sufficient data are available to consider autologous glutaraldehyde fixed pericardial leaflet replacement in highly selected younger patients with irreparable leaflets and contraindications to warfarin [89]. Lausberg et al. [9] described how aortic regurgitation can be effectively treated by aortic valve repair using an autologous HP patch. A method describing the rapid fabrication of an pericardial aortic heart valve using autologous HP, which involved brief dipping in glutaraldehyde to prevent shrinkage and thickening of the untreated tissue, was documented in a recent report by Liu et al. in 2013 [90]. This study demonstrated a favorable functional profile and excellent haemodynamic performance (peak pressure gradient: 7.70 ± 3.41 mmHg; mean pressure gradient: 1.79 ± 0.64 mmHg) of autologous HP valve replacements in a long-term follow-up (11.43 ± 4.50 years), even in younger patients (mean age, 34 years). Only 20% of the patients required reoperation for fibrocalcific degeneration [90]. Ozaki et al. [91] demonstrated that aortic valve reconstruction is feasible using glutaraldehyde-treated autologous HP in patients with various aortic valve diseases who are aged less than 60 years. Postoperative echocardiography revealed a normal peak gradient of 13.8 ± 3.7 mmHg 3.5 years after surgery, and freedom from reoperation was 96.2% at 53 months follow-up.