1,721,255 research outputs found
The question of preference for Ross operation in adolescents
No full textChoice of ideal aortic valve in grown up
The role of LV in the autograft complication after ROSS operation.
No full textRelative role of LV in autograft dysfunction in neonates and infants versus pre-school and school-age children
The Ross procedure in the young: evidence from multicentre registries.
No full textEvidence coming from the few multicenter prospective trials on the Ross operation
Repair of acute type A aortic dissection in comatose patients.
No full textOutcome of repair of acute type A aortic dissection in patients presenting with neurological dysfunction, including coma
Invited commentary.
No full textCommentary on critical issue with the Ross procedure in adult patients
Valve surgery in congenital heart disease.
No full textCongenital valve disease (CVD) occurs in iso- lated form or as part of complex malformations and pre- sents distinct epidemiology, including: young age at onset; high prevalence of associated pathology; history of prior operations; critical clinical presentation. Therefore, mul- tiple interventions are often needed, highlighting the pal- liative character of CVD surgery. At the same time, long- term survival and satisfactory quality of life expectations must be satisfied in a young, active patient population. The present study analyzes the unique aspects of surgery for CVD by reviewing clinical experience with 565 consecu- tive patients operated during a 7-year period. Treatment options and outcome are assessed with reference to the ability of respecting the unique demands of patients with CVD. In addition, future developments of CVD manage- ment are discusse
Intolerably high risk in ascending aortic surgery
No full textLimitations of totally catheter-based approach to treat aortic pseudoaneurysm after aortic valve replacement
Stentless aortic valve replacement: current status and future trends.
No full textStentless aortic xenografts were introduced into clinical practice as aortic valve substitutes over a decade ago. Stentless prosthetic valves were expected to provide enhanced durability and more physiologic hemodynamic behavior when compared with stented bioprostheses. Whilst the former expectation has not been fulfilled, partly due to concomitantly improved durability of second-generation stented bioprostheses, the latter has consistently been satisfied in early and late clinical observation. Evidence is accumulating suggesting improved long-term survival due to more timely and thorough regression of ventricular hypertrophy. In addition, stentless xenografts have shown extreme versatility when adopted in a variety of complex clinical conditions associated with aortic valve disease, including small aortic anulus, ascending aortic aneurysm, endocarditis and left ventricular dysfunction. Future research in the form of prospective, multicenter, randomized trials must address the issues of very long-term durability and survival, while simplification in valve design is required to promote wider use of stentless valves
Aortic root disease after the Ross procedure.
No full textPURPOSE OF REVIEW: Autograft root pathology is the most common adverse event late after the Ross operation. Therefore, characterization of prevalence, risk factors and natural history of root disease, as well as identification of preventive and therapeutic strategies, is warranted. RECENT FINDINGS: Autograft root pathology affects up to one third of long-term survivors of the Ross operation. Root replacement technique and preoperative aortic aneurysm are recurrent risk factors. Any age group, except for infants, may be affected. Dilatation is often progressive leading to valve regurgitation, true aneurysm, and, rarely, dissection. Primary prevention involves avoidance of root technique, graft repalcement of aneurysmal aorta, or modifications of the root technique. Use of beta-receptor antagonist or angiotensin converting enzyme-inhibitors for secondary prevention is still empirical. Indications to resection of root aneurysm are based on maximum root area indexed to body height. Reintervention prior to appearance of relevant valve insufficiency increases likelihood of pulmonary valve preservation. Definition of functional outcome after autograft valve-sparing procedures needs longer follow-up. SUMMARY: Over a decade after worldwide embracement of the root replacement technique for the Ross procedure, autograft root pathology is emerging as a prevalent complication. Prophylactic and therapuetic strategies are proposed to mitigate the current and future impact of this phenomenon
Minimal-access median sternotomy for aortic valve replacement
No full textA variety of minimally-invasive approaches for aortic valve replacement (AVR) have been developed and are increasingly being utilized. The different approaches described, such as partial upper sternotomy, right parasternal thoracotomy or transverse sternotomy have the aim to decrease invasiveness and reduce surgical trauma. Whereas port access surgery with remote cannulation has the attendant risks inherent with peripheral cardiopulmonary bypass and limitations in terms of myocardial protection and adequate cardiac dearing, partial sternotomies or thoracotomies may be associated with suboptimal chest wall reconstruction. Here described is a technique of minimal-access aortic valve replacement, which entails limited skin incision and full median sternotomy. Advantages of the present approach include a superior cosmetic result, when compared to standard sternotomy incision, and the safety of the midline access, which may be immediately converted into standard approach, in case of need, and is associated with stable chest wall reconstruction. Selective indications and outcome of minimal-access AVR are discussed
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