China
Africa
Explore chapters and articles related to this topic
Valvular Heart Disease and Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Kali Polytarchou, Constantina Aggeli
Patients with aortic root or ascending aorta aneurysm should undergo aortic valve repair or replacement, irrespective of the severity of valvular disease. In general, surgery is recommended for patients with aortic dimension ≥55 mm. In Marfan syndrome, surgery is recommended when the ascending aorta dimension is ≥50 mm or ≥45 mm with concomitant risk factors (such as personal or family history of aortic or other vascular dissection, severe aortic or mitral regurgitation, desire for pregnancy, arterial hypertension, or annual increase of aortic diameter ≥3 mm/year). Patients with Loeyz–Dietz syndrome or TGFBR1 or TGFBR2 gene mutations should undergo surgery when aortic dimension is ≥45 mm. Patients with bicuspid aortic valve or coarctation of the aorta and presence of the above risk factors should procced to surgery when aortic dimension is ≥50 mm. For patients with an indication for aortic valve replacement or repair, aortic root and ascending aorta replacement is indicated when dimension is ≥45 mm.21
Investigation of Sudden Cardiac Death
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Infective endocarditis is associated with significant morbidity and mortality in patients with adult congenital heart disease.52 In a recent study we published on 30 cases, the main lesion was a bicuspid aortic valve. SCD is due to perforation of the valve leaflets or embolization into the coronary circulation.53 Endocarditis can occur in CHD especially with interventions and valve replacements.54
Adult Congenital Heart Disease
Published in Takahiro Shiota, 3D Echocardiography, 2020
Pastora Gallego, Silvia Montserrat
The 3D aortic valve rendering in motion allows discrimination between a TV and a bicuspid valve with a raphe that mimics a commissure, the latter showing a fish-mouth opening. By 2D echocardiography, false-positive diagnosis of bicuspid aortic valve may arise from incomplete demonstration of all three-valve closure lines due to inadequate aortic valve cross sections.33
Conventional aortic root vs valve-sparing root replacement surgery in aortic dilatation syndromes: a comparison of mortality and postoperative complications
Published in Expert Review of Cardiovascular Therapy, 2023
Hashrul N Rashid, Omar Chehab, Harriet Hurrell, Vitaliy Androshchuk, Agata Sularz, Tiffany Patterson, Gianluca Lucchese, Simon Redwood
The durability of aortic root repair in the bicuspid aortic valve has previously been investigated. The bicuspid valve anatomy may be challenging to repair due to greater leaflet calcification, associated aortopathy and cusp abnormalities. A large single-center study demonstrated good survival rates of 93.2% at greater than 15-year follow-up. When further analyzed, predictors of death were lack of suture annuloplasty (OR 23, p < 0.01) and presence of limited valve calcification (OR 4.1, p < 0.01) [44]. Another study compared two annuloplasty strategies; the Cabrol technique (plication of the aortic valve leaflet triangle for circumferential reduction) and the El Khoury reimplantation technique, a modified David reimplantation procedure that involves deeper external aortic root dissection and reimplantation of the commissures at 180 degrees [45]. The El Khoury reimplantation technique was superior at 12-year follow-up, with superior freedom from reoperation and significant AR, compared to the Cabrol technique. There were no differences in overall survival between the two cohorts.
Progress in surgical interventions for aortic root aneurysms and dissections
Published in Expert Review of Cardiovascular Therapy, 2022
Shamini Parameswaran, Bulat A. Ziganshin, Mohammad Zafar, John A. Elefteriades
Valve sparing surgery that is being considered in a patient with a bicuspid aortic valve raises additional complexities. The incidence of bicuspid aortic valves is approximately 2% within the population [18] and bicuspid valve is frequently found to be associated with ascending aortic aneurysms (about 10% of cases with bicuspid valve or complex congenital anomalies) [29,30]. In fact, these patients tend to present at an earlier age compared with those who have degenerative aortic aneurysmal disease [31–34] and have more than a 25-fold increased risk in developing an ascending aortic aneurysm compared to the general population [35]. It is believed that the patients with bicuspid valves are at risk for regurgitation or stenosis or both. When there is moderate or greater aortic insufficiency, this leads to an increased stroke volume and higher aortic wall stress that may contribute to the ascending aortic dilation [34,36–38].
Early, Single Center Experience with Ozaki Technique for Aortic Valve Reconstruction
Published in Structural Heart, 2020
Alberto Albertini, Eliana Raviola, Simone Calvi, Alberto Tripodi, Paola Quagliara, Fabio Zucchetta, Elisa Mikus
Results: The mean age was 52.95 ± 14.72 years old (21–74 years, 76.2% male). The predominant pathology was aortic valve stenosis (61.9%) followed by aortic regurgitation (33.3%) and one patient was treated for endocarditis (4.7%). Nine patients (42.8%) presented with a bicuspid aortic valve and in one patient a monocuspid valve was found. Concomitant procedures included: coronary arteries by-pass grafts (5 patients, 23.8%), ascending aorta replacement (1 patient, 4.7%), mitral valve valvuloplasty (5 patients, 23.8%), interventricular septal myectomy (1 patient, 4.7%). The mean aortic cross-clamp time and cardiopulmonary bypass time were respectively 131.95 and 119.57 minutes. All patients have been extubated (mean intubation time 9.76 ± 4.99 hours) and intensive care unit and hospital stay was respectively 2.5 ± 1.25 and 6.10 ± 4.68 days. There was no in-hospital mortality. Transthoracic echocardiography showed a peak aortic pressure gradient of 14.09 ± 7.62 mmHg and a mean aortic pressure gradient of 7.91 ± 3.33 mmHg. Aortic valve regurgitation was trivial in 8 patients (38%) and no valve stenosis was detected.