Choosing aortic valve plasty for aortic root/ascending aorta repair

Чарчян, Э. Р.; Белов, Ю. В.; Скворцов, А. А.; Salagaev, G. I.; Шведов, П. Н.

doi:10.21688/1681-3472-2016-2-26-34

Cited by 5 publications

(1 citation statement)

References 22 publications

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“…Б. В. Петровского была начата программа малоинвазивной хирургии грудной аорты [4], выполнено более 450 вмешательств на восходящем отделе аорты (ВоА) и дуге аорты. Из них в 106 случаях пациентам с аневризмой корня аорты в сочетании с / или без аортальной недостаточности (АН) была выполнена клапансохраняющая реимплантация собственного АК в сосудистый протез по оригинальной методике David и ее модификации [5] с использованием во всех случаях тепловой кровяной кардиоплегии [6]. Из мини-доступа было выполнено 35 (33 %) вмешательств.…”

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Results of Minimally Invasive Valve-Sparing Aortic Root Valve Surgery: Propensity Score Matching Analysis

2020

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Aim Evaluation of efficacy and safety of minimally invasive, valve-sparing interventions on the aortic root and a comparative analysis of outcomes versus a group of patients with a complete sternotomy intervention using the method of propensity score matching (PSM).Materials and methods From 2016 through 2019, 458 interventions on the aortic root were performed, including 160 (36.6 %) interventions with mini-sternotomy. The study included 106 patients with the valve-sparing surgery (David procedure). Two groups of 30 patients each were formed using PSMC: group 1, complete sternotomy (CS) and group 2, J-shaped mini-sternotomy (MS). Immediate and long-term outcomes were evaluated at 13.8±10.3 (1–38 months (min-max) in the MS group and 42±21 (1–61 months (min-max) in the CS group.Results Statistically significant differences in death rate, echocardiographic indexes, absence of reoperations and complications in the postoperative period were not observed. In group 2, durations of extracorporeal circulation (p=0.04) and period of myocardial ischemia (p=0.004) were increased. The same group showed decreased intraoperative blood loss (p=0.001), postoperative drainage losses (p=0.0001), extubation time (р=0.0001), duration of stay in resuscitation and intensive care units and in the department of reconstructive recovery cardiovascular surgery (p=0,005).Conclusion The David procedure with mini-sternotomy is a safe and effective alternative to the traditional approach. This technique significantly reduces the time of rehabilitation and duration of patients’ stay in the hospital without significant differences in the long-term period, which suggests advantages of this method. However, despite these promising results, the retrospective nature of this study, a small sample of patients, and a short follow-up period warrant further study.

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Results of Minimally Invasive Valve-Sparing Aortic Root Valve Surgery: Propensity Score Matching Analysis

2020

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Changes in aortic root dimensions after ascending aortic repair with concomitant aortic valve replacement

et al. 2022

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The issue of ascending aortic repair with concomitant aortic valve replacement in pa-tients with ascending aortic aneurysm (AscAA) and aortic valve stenosis is still debatable.Aim. To analyze the dimension changes of the preserved aortic root after simultaneous ascending aorta repair and aortic valve replacement.Material and methods. This retrospective study included 102 patients who, from December 2012 to May 2022, underwent simultaneous aortic valve replacement and ascending aorta repair with hemiarch replacement. Patients were divided into 2 following groups based on the aortic valve morphology: group 1 — patients with bicuspid aortic valve (BAV) and AscAA (n=75), group 2 — patients with tricuspid aortic valve (TAV) and AscAA (n=27). Depending on the presence of aortic root dilatation (maximum diameter (d) >40 mm), each of the groups was additionally stratified into 2 more subgroups as follows: patients without aortic root dilatation (d≤40 mm) and patients with its dilatation (d>40 mm). The dynamics of the aortic root diameter was assessed by computed tomography angiography.Results. The mean follow-up period for patients was 36,2±14,6 months. Survival rate in the BAV+AscAA and TAV+AscAA groups was 96% and 100%, respectively (p=0,380). Freedom from aortic root resurgery was 100% in both study groups. In patients with dilated and non-dilated aortic root of the BAV+AscAA group, an increase in aortic root dimension was noted at a rate of 0,65±0,51 mm/year and 0,32±0,27 mm/year, respectively. In patients of the TAV+AscAA group, a regression in dilated and non-dilated aortic root diameter was observed as follows: 0,93±0,48 mm/year and 0,56±0,43 mm/year, respectively.Conclusion. In patients with AscAA in combination with BAV stenosis after a singlestep surgical intervention, a weak negative dynamics of non-dilated and dilated aortic root is observed in the mid-term follow-up period. In patients with AscAA and TAV, there is involutive alterations of the aortic root dimension during 3-year follow-up.

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Blood loss as the main cause of organ dysfunction after simultaneous ascending aorta and aortic arch replacement

Rizun,

Vinokurov,

Akselrod

et al. 2024

Kardiol. serdechno-sosud. khir.

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Choosing aortic valve plasty for aortic root/ascending aorta repair

Cited by 5 publications

References 22 publications

Results of Minimally Invasive Valve-Sparing Aortic Root Valve Surgery: Propensity Score Matching Analysis

Results of Minimally Invasive Valve-Sparing Aortic Root Valve Surgery: Propensity Score Matching Analysis

Changes in aortic root dimensions after ascending aortic repair with concomitant aortic valve replacement

Blood loss as the main cause of organ dysfunction after simultaneous ascending aorta and aortic arch replacement

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