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Results for “AORTIC VALVE”

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At least 19 recordsLinked to original sources
PubMed1997

[Minimally invasive approach for mitral valve, aortic valve, and atrial septal defect surgery].

We successfully introduced minimally invasive cardiac surgery (MICS) to japan by performing thoracoscopic clipping of a patent ductus arteriosus in July 1992. MICS via a small right parasternal incision (Cosgrove procedure) was applied for one patients with severe rheumatic mitral stenosis, one with severe aortic regurgitation, and one with atrial septal defect (ASD). Mitral valve replacement (MVR), aortic valve replacement (AVR), and direct closure of the ASD were performed successfully by MICS for the the first time in Japan. All three patients required no blood transfusion and had no complications postoperatively, being discharged from hospital at 15, 13, and 9 days after their operations. MICS was satisfactory for mitral valve and ASD operations, but AVR by this approach took much longer than by standard midline sternotomy due to the poor surgical field obtained via the small right parasternal incision. A minimally invasive approach for surgery on the aortic valve and ascending aorta may require transection of the sternum or some other method. MICS has several advantages, including less trauma and pain, faster patient recovery, shorter ICU and hospital stays, a lower cost, and a better cosmetic outcome. Therefore, it is better for the patient when it is feasible. MICS should develop and be applied to more patients with cardiovascular disease in the future. Some of the standard cardiovascular operations may soon be replaced by MICS.

Adult↗
PubMed1985

[Aortic ring abscess following bacterial endocarditis of the aortic valve and aortic valve replacement].

Valve replacement was performed in a 30-year-old male patient with acute aortic insufficiency due to bacterial endocarditis. During a routine examination three months later, an aortic ring abscess was found by echocardiography. In the following night, the patient was readmitted with acute anterior myocardial infarction. Coronary angiography showed a compression of the left coronary artery by the large ring abscess of the aortic valve. 48 hours after surgical revision of the aortic valve prosthesis and the ring abscess, the patient died due to pump failure.

Abscess↗
PubMed1999

An exceedingly low operative mortality given by stentless autologous, homologous, and heterologous aortic valves for aortic valve replacement.

Homologous, autologous, and heterologous stentless valves were implanted into 663 patients undergoing aortic valve replacement by standard conventional methods. An exceedingly low mortality rate was achieved for the whole series, with the last consecutive 311 patients experiencing zero mortality. This analysis encompasses the hospitals' total experiences with these three stentless valves and examines only the low and zero mortalities. The three stentless valves were the aortic allograft used as a root replacement in 374 patients (mean age 43 years, 8.8% for active endocarditis), the pulmonary autograft used as a root replacement (22 patients, mean age 34 years) and the Cryolife O'Brien Model 300 stentless composite porcine glutaraldehyde-preserved aortic xenograft (267 patients, mean age 73 years, 16% 80 years or older, 55% concomitant procedures). Overall mortality rate was 1.1%. The seven deaths were essentially non-valve- and non-procedure-related. Of the last consecutive 311 patients, the mortality rate has been zero (166 allografts, 22 autografts, and 123 stentless xenografts). As a result of a careful, planned introduction of each valve and good experience and training in implant techniques, this low mortality and consecutive zero mortality suggest a "modern-day gold standard."

Adolescent↗
PubMed2000

[Aortic valve replacement for aortic valve stenosis due to congenital bicuspid aortic valve with abnormal positioning of coronary orifice, pseudotendon, and persistent left superior vena cava, report of a case].

A patient was a 65-year-old female who had a complaint of palpitation was diagnosed aortic valve stenosis due to congenital bicuspid aortic valve with pseudotendon by the echocardiographic examination. We suspected left single coronary artery by the aortography and the coronary artery angiography. Aortic valve replacement and resection of pseudotendon was performed with Carbomedics supra-annular aortic valve (21 A). During surgery, persistent left superior vena cava was detected. High-posterior take-off right coronary artery was casually detected at aortic closure. Ventricular fibrillation due to insufficient supply of cardioplegic solution at right coronary area frequently occurred after cardio-pulmonary bypass and percutaneous cardiopulmonary support was required. The patient was discharged 32 days after the operation. Preoperative and intraoperative evaluation was important in the case of aortic valvular disease.

Aged↗
PubMed1992

[Echocardiographic assessment of aortic regurgitation and aortic root dilatation in bicuspid aortic valve].

Aortic regurgitation (AR) and aortic root dilatation in 29 consecutive patients with bicuspid aortic valves but without aortic root disease (20 males, and 9 females: aged 27-85 years) were studied using two-dimensional echocardiography. The normal ranges of aortic root dimensions were calculated from values of 185 normal subjects, as 95% confidence intervals. AR was observed in 17 patients by color flow mapping. In 12 of the 17 AR patients, no significant lesion of the aortic cusp was detected by two-dimensional echocardiography. These 12 AR patients were compared with 12 patients without AR. Increase in dimension of the aortic root was relatively frequent in the 12 AR patients at the aortic annulus (AA) (67 vs 17%, p < 0.05), and at the sinus of Valsalva (A1) (67 vs 17%, p < 0.05). At the ascending aorta 5 mm distal to the sinus of Valsalva (A2), the difference was not significant (58 vs 17%, p < 0.09). The 12 bicuspid AR patients without significant lesions of the aortic cusp were compared with 41 AR patients with normal tricuspid aortic valves. The frequencies of cases with increased aortic root dimension were 67 vs 46% (ns) at the AA, 67 vs 22% (p < 0.05) at A1 and 58 vs 5% at A2 (p < 0.01). Thus, aortic annular dilatation was thought to be the cause of AR in bicuspid and tricuspid aortic valves without significant lesions of the aortic cusps, and generalized dilatation of the aortic root was more frequent in bicuspid AR patients than in tricuspid AR patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Allograft aortic valve replacement: long-term comparative clinical analysis of the viable cryopreserved and antibiotic 4 degrees C stored valves.

Aortic valve replacement with or without concomitant procedures was performed using an allograft aortic valve in 534 patients. From December 1969 to May 1975 (group I), a 4 degrees C stored valve was used (124 patients) and from June 1975 to July 1990 (group II), a cryopreserved valve (410 patients) was used. The 30-day mortality was 8.9% (confidence limits [CL] 6.2%-12.3%) for group I and 2.7% (CL 1.9%-3.8%) for group II. Actuarial patient survival including early hospital mortality at 14 years was 57% for group I and 71% for group II (p = 0.014). Actuarial freedom from thromboembolism for all patients (n = 534) was 94% at 14 years, and for patients who underwent isolated aortic valve replacement with or without coronary artery bypass graft (n = 457) was 97% at 14 years (p = 0.017). Actuarial freedom from allograft valve endocarditis at 14 years was 92% in group I and 94% in group II (p = 0.36). The actuarial freedom from moderate or severe allograft valve incompetence at 14 years was 50% (group I) and 78% (group II) (p = 0.27). Reoperation was undertaken for endocarditis, leaflet structural deterioration (SD), or technical reasons. The actuarial freedom from reoperation (all causes) at 14 years was 63% (group I) and 86% (group II) (p = 0.39). Reoperation for SD occurred in 34 patients in group I and three patients in group II. The actuarial freedom from reoperation for SD at 14 years was 67% (group I) and 95% (group II) (p = 0.001). To reflect a more accurate depiction of the prevalence of SD, patients were analyzed according to the development of "assumed structural deterioration" (at reoperation, at death with moderate or severe allograft valve incompetence and macroscopic valve deterioration on autopsy, and in the presence of moderate or severe allograft valve incompetence in patients not undergoing reoperation). The actuarial freedom from "assumed structural deterioration" at 14 years was 51% (group I) and 85% (group II) (p = 0.000003). The long-term results confirm the low incidence of thromboembolism and endocarditis regardless of the method of preservation and demonstrate the overall acceptable performance of the viable cryopreserved allograft valve and its superiority over the 4 degrees C stored valve.

Actuarial Analysis↗
PubMed2001

[A case of minimal invasive aortic valve replacement for quadricuspid aortic valve with aortic regurgitation].

Congenital quadricuspid aortic valve is rare, which may be a cause of sever aortic regurgitation. We report a case of a 55-year-old man who had severe aortic regurgitation with congenital quadricuspid aortic valve. Preoperative aortography showed severe aortic regurgitation. Preoperative trans-esophageal echocardiography revealed abnormal quadricuspid aortic valve. We performed minimal invasive aortic valve replacement with SJM # 21 mm HP prosthetic valve through the limited upper sternotomy. Skin incision was 9 cm. Aortic cross-clamping time was 92 min, cardiopulmonary bypass time was 108 min. At the operation, a quadricuspid valve with three equal cusps and one small cusp was noted. The postoperative course was excellent and he discharged 8 days after the operation.

Aortic Valve↗
PubMed1994

The use of unstented homograft valves for aortic valve reoperations. Review of a twenty-three-year experience.

Unstented homograft valves offer several theoretical advantages when used for patients who have had previous operations on the aortic valve. Between January 1970 and February 1993, 177 patients received unstented homograft valves after previous aortic valve operations. One hundred thirty-four patients had previous aortic valve replacement in the form of homografts (101 patients), mechanical prostheses (24 patients), and bioprostheses (9 patients), and 43 had previous valve repair. The indication for reoperation was deterioration of a noninfected valve (124 patients), infective endocarditis (40 patients), and failure of a noninfected mechanical valve (12 patients). Fresh homograft valves were implanted in 60 patients, homografts preserved in antibiotics were used in 111 patients, and 6 patients received cryopreserved valves. Aortic valve and root replacement was performed in 60 patients, and in 117 the homograft was inserted freehand in the subcoronary position. The early mortality was 5.1%. The actuarial survival at 10 years was 71%. Multivariate analysis demonstrated that patients with previous homograft replacement have a better long-term survival than patients who had previous mechanical valves (p = 0.017). The freedom from valve-related death and reoperation was 70% at 10 years. Fresh homografts faired better than antibiotic-sterilized homografts (p = 0.007). None of the patients had recurrence of endocarditis at 6 months, although 1 patient died of uncontrolled infection despite valve replacement. The freedom from recurrent endocarditis was 88% at 10 years. We conclude that unstented aortic homografts provide good early and long-term results for aortic valve reoperations, particularly in patients with previous homograft replacement. Recurrent endocarditis is uncommon even in patients operated on for prosthetic valve infections.

Adolescent↗