Download Aortic Root Surgery: The Biological Solution by Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer PDF

By Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer

The surgical result of bioprosthetic aortic valve substitute within the Sixties and Nineteen Seventies weren't very passable. the quest for definitely the right alternative for the diseased aortic valve led Donald Ross to boost the concept that of the aortic allograft in 1962 and the pulmonary autograft in 1967 for subcoronary implantation, and later, in 1972, as a whole 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 background 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 perfect hemodynamics, giving sufferers a b- ter diagnosis 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 to be had. The- fore, surgeons are focusing their talents and their scientific and s- entific wisdom on optimizing the technical artistry of val- sparing methods.

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Extra info for Aortic Root Surgery: The Biological Solution

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Percutaneous transluminal aortic valve replacement: The CoreValve prosthesis z Patient population Patients with severe native aortic valve stenosis are eligible for CoreValve implantation if they meet the following inclusion criteria: z a native aortic valve stenosis with an aortic valve area < 1 cm2 z aortic valve annulus diameter ≥ 20 mm and ≤ 27 mm, measured by means of echocardiography or CT z diameter of the ascending aorta 3 cm above the annulus of ≤ 43 mm; z high risk for surgery due to concomitant comorbid conditions, assessed and agreed to by both a cardiologist and a cardiothoracic surgeon.

TA-AVI – setup z The OR The most important difference in transcatheter AVI compared to conventional techniques is the (almost) closed chest situation not allowing for direct vision of the working field. Therefore, optimal imaging is of utmost importance to ensure precise positioning of the prosthesis – the key step in 35 36 z J. Kempfert et al. any transcatheter AVI. The most suitable environment is a fully equipped hybrid-OR combining high quality fluoroscopy/angiography, transesophageal echo (2D and 3D/X-plane), cardiopulmonary bypass (on standby), and standard cardiac surgical equipment allowing for bailout to all conventional surgical techniques.

Circulation 90(Part 2):II-198–204 15. Yankah AC, Pasic M, Klose H, Siniawski H, Weng Y, Hetzer R (2005) Homograft reconstruction of the aortic root for endocarditis with periannular abscess: a 17year study. Eur J Cardiothorac Surg 28:69–75 16. Yankah AC, Sievers HH, Buersch JH, Radtcke W, Lange PE, Heintzen PH, Bernhard A (1984) Orthotopic transplantation of aortic valve allograft. Early hemodynamic results. Thorac Cardiovasc Surgeon 32:92–95 17. Mogovern GJ, Kent EM, Cromie HW (1962) Sutureless artificial heart valves.

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