By Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer
The surgical result of bioprosthetic aortic valve substitute within the Nineteen Sixties and Nineteen Seventies weren't very passable. the quest for the precise replacement for the diseased aortic valve led Donald Ross to increase the idea that of the aortic allograft in 1962 and the pulmonary autograft in 1967 for subcoronary implantation, and later, in 1972, as an entire root for changing the aortic root within the contaminated aortic valve with a root abscess. The aortic al- graft and pulmonary autograft surgeries have been revo- tionary within the heritage of cardiac valve surgical procedure within the final m- lennium simply because they compete good with the bioprosthesis, are nonthrombogenic (thus, requiring no postoperative anticoa- lation), are immune to an infection, repair the anatomic devices of the aortic or pulmonary outflow tract, and provide unimpeded blood circulation and ideal hemodynamics, giving sufferers a b- ter analysis and caliber of existence. surgical procedure for congenital, degenerative, and inflammatory aortic valve and root ailments has now reached a excessive point of adulthood; but a great valve for valve substitute isn't on hand. The- fore, surgeons are focusing their abilities and their medical and s- entific wisdom on optimizing the technical artistry of val- sparing strategies.
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Extra info for Aortic Root Surgery: The Biological Solution
Gerckens et al. Conclusions There is certainly a large need in cardiology for the development of an effective, interventional method for the treatment of degenerative calcified aortic valve stenosis. This need is not only necessitated by the large number of the patients who are considered inoperable for traditional open heart surgery, but also by the troublesome and potentially complicated course of thoracotomy, extracorporeal circulation, prolonged mechanical ventilation, etc. After the initial safety and efficacy trials, the ongoing European CoreValve registry demonstrates a high rate of procedural success and a low 30day mortality in a large cohort of high-risk patients undergoing transcatheter aortic valve implantation with the CoreValve prosthesis.
Z Iliac & femoral vessels (diameter) × AO & runoffs z Aorta & run-off vessels (disease) × × Coronary angiogram × × LV AO gram gram z AO arch angulation CT/ MRI Angiography × Echo Non-invasive z Ascend aorta (width) Anatomy Table 1 (continued) Borderline ≥ 7 mm None Large-radius turn Non-diabetic ≥ 6 mm Mild ≤ 40 mm–26 mm device ≤ 43 mm–29 mm device Preferred Selection criteria < 6 mm Moderate to severe High angulation or sharp bend > 43 mm Not acceptable Percutaneous transluminal aortic valve replacement: The CoreValve prosthesis z 25 26 z a U.
Ann Thorac Surg 75:803–808 6. American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease); Society of Cardiovascular Anesthesiologists, Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. Circulation 114:e84–e231 7. Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999) Association of aortic valve sclerosis with cardiovascular mortality and morbidity in the elderly.