Early results with annular support in reconstruction of the bicuspid aortic valve

Aicher, Diana; Schneider, Ulrich; Schmied, Wolfram; Kunihara, Takashi; Tochii, Masato; Schäfers, Hans‐Joachim

doi:10.1016/j.jtcvs.2012.11.059

Cited by 114 publications

(95 citation statements)

References 27 publications

(57 reference statements)

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“…The heterologous pericardium is a very suitable material to use (59). (III) Annulus stabilization: an aorto-ventricular junction >28 mm contributes to repair failure (60). Stabilization with annuloplasty with suture (60) or with ring (61) provides good long-term results.…”

Section: Surgical Aspects: a Place For Repair?mentioning

confidence: 99%

Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity

et al. 2017

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Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease.It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects. Pathology of BAV is still not well known and many questions are unresolved. In this manuscript we review some aspects on bicuspid aortopathy, a heterogeneous and frequent disease in which like some authors have previously described, complex gene environment are present. Further investigations and, what is more, multidisciplinary teams are needed to improve our knowledge on this really fascinating disease.

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Section: Surgical Aspects: a Place For Repair?mentioning

confidence: 99%

Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity

et al. 2017

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“…The reimplantation technique or the use of the external ring may clash with anatomical problems, because in the right coronary sinus the basal ring and the AVJ are very distant in 20-30% of cases (11). The use of the annuloplasty with suture avoids these anatomical problems.…”

Section: Techniques On the Aortic Annulus (Figure 1)mentioning

confidence: 99%

“…Stabilization of the aortic annulus is essential for the durability of the repair. This can be achieved with three techniques, subcommissural plicature (10), ring annuloplasty (12) and annuloplasty with suture (11). The subcommissural plicature is the simplest to perform and consists of three points supported on Teflon that are applied in the annulus closing the intercommissural triangles in its superior half.…”

Section: Commentsmentioning

confidence: 99%

“…External ring annuloplasty offers good long-term results (12), but presents more difficulties in implantation (the stitches are similar to those made when performing the reimplantation technique); and is a prosthetic material that can raise the cost of repair, although in some centers without availability it is replaced by a segment of Dacron tube. In the Figure 1, we show three cases with PTFEsuture annuloplasty (11), it is the technique we do in our group because we believe that combines durability, ease of performance, and can be used as an adjunct to aortic remodeling surgery and isolated aortic repair procedures.…”

Section: Commentsmentioning

confidence: 99%

“…AR without dilatation of the root, by mechanisms such as annulus dilatation, leaflet prolapse, leaflet defect or sinotubular junction dilatation are causes that can be repaired surgically. For annulus dilatation some techniques have been described for years, for example the subcommissural plicature by Cabrol et al (10), others are more recent such as annuloplasty with suture (11) or with ring (12). In addition, the extension with pericardium (13) to correct the defect of the leaflets, the central plication (14) or the leaflet resuspension with polytetrafluoroethylene (PTFE) (15) for the treatment of valvular prolapse and remodeling of the sinotubular junction (16) are techniques that employed together allow good results by remaining above 80% free of reoperation at 5 years (16,17).…”

Section: Introductionmentioning

confidence: 99%

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Sparing aortic valve techniques

Álvarez-Cabo

2017

J. Thorac. Dis.

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Prosthetic valve implantation is the most widely used therapeutic option for aortic regurgitation (AR), but complications associated with prosthetic valves, with an incidence of 3-5% patient/year, and the need for anticoagulation in mechanical valves, force us to consider aortic valve repair as an alternative to the prosthetic implant, especially in young people with many potential years of life for these complications.Aortic valve repair techniques are not excessively complicated, but there is no standardization, so they are not reproducible in all medical centers. There are multiple repair procedures, but to study them we can divide, arbitrarily, into two large groups, techniques for treatment of aortic root dilatation (reimplantation and remodeling); and repair techniques without treatment of the aortic root, that act on annulus and on aortic leaflets. The two sets of techniques are often used together, but it is easier to understand them if this arbitrary division is made. Our goal is to publish our experience and knowledge of repair techniques to facilitate their learning by other professionals. In this article, we will focus on the procedures on the aortic annulus and leaflets, because they can be applied in patients without aortic root dilatation, but they are also complementary to the reimplantation and remodeling techniques. We will present the procedures describing them individually, with an explanation in text accompanied by three videos in which the application of each technique is visualized in several cases. The standardization of sparing aortic valve techniques is difficult, because each patient requires its individualized application, yet we have tried to illustrate reproducible procedures so that professionals have more tools to deal with aortic valve-preserving surgery.

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External Aortic Ring Annuloplasty to Standardize Aortic Valve Repair

Lansac

Centa

2018

Advances in Treatments for Aortic Valve and Root Diseases

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Early results with annular support in reconstruction of the bicuspid aortic valve

Abstract: Preservation of the bicuspid aortic valve is feasible in many patients. Long-term stability of the repaired valves is good; the negative impact of a dilated atrioventricular junction can be reduced by suture annuloplasty.

Cited by 114 publications

References 27 publications

Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity

Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity

Sparing aortic valve techniques

External Aortic Ring Annuloplasty to Standardize Aortic Valve Repair

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