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Minimally Invasive Aortic Valve Replacement
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
AVR and ascending aorta (Bentall procedure) (Figures 7.2.12, 7.2.13), aortic root replacement, valve-sparing aortic root replacement (David procedure) (Figure 7.2.14) and a manubrium-limited aortic procedure can also be carried out by using the upper J mini-sternotomy approach (Figure 7.2.11, Figure 7.2.12, Figure 7.2.13 and 7.2.14).
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
The rate of repair of the spared bicuspid valve was found to be low (14%) in the meta-analysis performed by Arabkhani et al, and it was also noted that the bicuspid aortic valve was not associated with a higher reoperation hazard. However, it was noticed that bicuspid patients who had severe aortic insufficiency pre-operatively had a trend toward higher reoperation hazard [39]. A report by Schaffers and colleagues [40] emphasized that asymmetric cusp prolapse, which was determined by measuring the effective height of the cusp with a dedicated caliper, should be corrected during valve sparing root replacement in order to avoid subsequent aortic regurgitation. In sum, if the preoperative aortic regurgitation is less than severe and the patient has lifestyle or medical indications for preservation of an aortic valve, a valve sparing aortic root replacement can fairly be considered.
Improving Aortic Repair Outcomes: A New Device for Echocardiographic Valve Assessment During Cardioplegic Arrest
Published in Structural Heart, 2020
Christian Dinges, Johannes Steindl, Michael Kirnbauer, Johann Fierlbeck, Michael Krieghofer, Wolfgang Hitzl, Lynne Hinterbuchner, Andreas Winkler, Rainald Seitelberger
Objective: Valve sparing aortic root replacement is a complex surgical procedure. However, unlike for mitral valve repair, there is no possibility to evaluate post repair valve competence during cardioplegic arrest. Our group developed the Aortic Root Pressurizing Device (ARPD) to address this problem. This surgical tool can be connected to every standard aortic Dacron graft. By mimicking diastolic afterload, it enables intraoperative echocardiographic aortic valve evaluation already during cardioplegic arrest.
Aortic Root Surgery for Ascending Aortic Dilatation and/or Valve Regurgitation: Short-term Patient and Valve-related Outcome from the AVIATOR Database
Published in Structural Heart, 2020
Bardya Arabkhani, Robert Klautz, Mark Hazekamp, Frederiek de Heer, Laurent de Kerchove, Gebrine El Khoury, Emmanuel Lansac, Sarah Pousset, Hans-Joachim Schäfers, Ismail El-Hamamsy, Marien Lenoir, José Aramendi, Alejandro Crespo, Bart Meuris, Peter Verbrugghe, Jolanda Kluin, Dave Koolbergen, Olivier Bouchot, Igor Rudez, Davor Baric, Mauro Masat, Adrian Kolesar, Tomas Toporcer, Thomas van Brakel
Objective: Valve-sparing aortic root replacement has gained popularity in the last decade. This report provides short-term outcome and differences between patients after valve-sparing versus valve-replacement procedures, applying the Heart Valve Society’s AVIATOR database.