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Valvular Heart Disease and Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Kali Polytarchou, Constantina Aggeli
About two out of three cases of aortic regurgitation are caused by degenerative bicuspid or dysplastic aortic valves.21 Other causes are infective endocarditis, rheumatic disease, ventricular septal defect, post TAVI or balloon valvulotomy, radiation, drugs, or collagenic autoimmune disease, such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, and Adamantiades-Behcet syndrome, which can affect both the aortic valve and the ascending aorta. Arterial hypertension, Marfan syndrome, annuloaortic ectasia, Loeys–Dietz syndrome, Ehler-Danlos syndrome, Turner syndrome, syphilis, psoriasis, Takayasu arteritis, and giant cell arteritis are diseases that cause aortic dilatation and aortic regurgitation. Trauma, infective endocarditis, or acute aortic dissection are causes of acute aortic regurgitation.
Congenital cardiac anomalies
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Marfan’s syndrome is caused by mutations in the fibrillin gene. It consists of musculoskeletal abnormalities (tall, thin, extremity length out of proportion to trunk length, arachnodactyly, pectus excavatum and hyperextensible joints), ocular abnormalities (subluxation of the lens, myopia) and cardiovascular abnormalities (annuloaortic ectasia, aortic aneurysm and aortic dissection, mitral valve prolapse and mitral regurgitation, and atrial dysrhythmias).
Collagens of Normal and Diseased Blood Vessel Wall
Published in Marcel E. Nimni, Collagen, 1988
An aneurysm is defined as a dilation of the vessel concerned and may ultimately lead to rupture of the affected vessel. Aortic aneurysm is relatively common in the aging aorta and aneurysm of the abdominal aorta frequently occurs in association with atherosclerosis. Dilatation of the proximal aorta, together with dilatation of the aortic root and valvular insufficiency, has been described as a specific entity, annuloaortic ectasia. This condition is frequently associated with Marfan’s syndrome (see Section V.F), but may occur in isolation in the absence of any other obvious connective tissue defects. In cases of the isolated disease, there is evidence that the amount of collagen may sometimes be increased in the affected vessel relative to the amount of elastin.104
Partial outflow pump dehiscence following off-pump HeartWare left ventricular assist device implantation in a patient with the Marfan syndrome
Published in Baylor University Medical Center Proceedings, 2019
Mina M. Benjamin, David L. Joyce, Asim A. Mohammed
Off-pump implantation of LVAD has been reported4–7 but not in MFS patients. There are limited data on the impact of continuous-flow LVAD in MFS patients. Ishino et al8 reported two patients with MFS undergoing temporary LVAD support. One, a 22-year-old with annuloaortic ectasia and DeBakey type II dissection, had been supported by LVAD for 87 hours after composite graft replacement of the ascending aorta and aortic valve. The second patient, a 52-year-old with annuloaortic and DeBakey type I dissection, had been supported by LVAD for 91 hours after aortic valve replacement. The first patient died of multiple organ failure on the 62nd postoperative day, but the second returned to work after surgery. Tschirkov et al9 reported a 26-year-old man with MFS who was implanted with a Berlin Heart INCOR system. The Bentall/DeBono procedure with a Carbonart 27/30 conduit (Sorin Biomedica Cardio S.p.A, Via Crescentino, Italy) was performed before the Berlin Heart INCOR implantation. The outflow cannula of the device was implanted in the conduit. Dehiscence of the outflow cannula of LVADs is a complication of LVAD implan-tation in the native aorta of patients with connective tissue disorders, including MFS.
Percutaneous device closure of an aorto-right ventricular outflow tract fistula after Bentall repair
Published in Acta Cardiologica, 2021
Arun Gopalakrishnan, Kavassery Mahadevan Krishnamoorthy, Sivasankaran Sivasubramonian, Ajitkumar Valaparambil
A 43-years-old gentleman was diagnosed with a complex endoleak during evaluation of new onset NYHA class II exertional dyspnoea and heart failure 15 years after Bentall de-Bono repair with a 25 mm Chitra tilting disc aortic valve replacement and a 28 mm Hemashield graft (Macquet Cardiovascular) replacement of the ascending aorta for annuloaortic ectasia, ascending aortic aneurysm and severe aortic regurgitation. Multiple perigraft saccular pseudoaneurysms were identified from the ascending aorta with an aorto right ventricular outflow tract fistula [1]. The patient was not willing for a high-risk surgical resection of the pseudoaneurysm and Dacron graft augmentation of the ascending aorta. Hence, he was considered for percutaneous device closure of the fistula.
Geometrical Correlation Between The Right And Left Ventricular Outflow Tract In Young Bav Vs. Tav Patients: Implications For The Ross Procedure
Published in Structural Heart, 2019
Shiho Naito, Hermann Reichenspurner, Evaldas Girdauskas
Methods: A total of consecutive 43 patients between 20 and 70 years old who were referred for aortic valve operation and underwent preoperative MDCT between January 2016 and June 2018, were retrospectively analyzed. Patients with aortic root/ascending aortic aneurysm or annuloaortic ectasia were excluded. Based on preoperative transesophageal echocardiography, a total of 35 patients were diagnosed with BAV, whereas the remaining 8 patients had TAV. Using MDCT, the diameter of aortic valve (AV) annulus and pulmonary valve (PV) annulus, left and right ventricular outflow tract were measured and compared in BAV vs. TAV patients.