Aortic Root Remodeling in Acute Aortic Dissection.

Objectives: To evaluate the long-term results of remodeling in acute aortic dissection type A (AADA) to define operative risk and root and valve stability.

Methods: Between October 1995 and December 2018, a total of 352 patients were treated surgically for AADA. Of these, 90 patients with AADA (<2 weeks from onset; age: 57 ± 15 years; 70 males) with a root diameter of >43 to 45 mm (depending on patient size) (48 ± 4.

Aortic root remodeling in bicuspid and tricuspid aortic valves-long-term results.

Background: Root remodeling is one form of valve-preserving root replacement to treat patients with aortic regurgitation (AR) and root aneurysm. We have consistently used it for patients with and without connective tissue disease and different aortic valve morphologies. The objective of this retrospective study was to review 23 years of experience with root remodeling.

Geometry of cusp and root determines aortic valve function.

The aortic valve is the functional unit of cusp and root. Various geometrical and functional analyses for the aortic valve unit have been executed to understand normal valve configuration and improve aortic valve repair. Different concepts and procedures have then been proposed for reparative approach, and aortic valve repair is still not standardized like mitral valve repair.

Unicuspid aortic valve repair with bicuspidization in the paediatric population.

Objectives: Aortic stenosis or regurgitation that requires operations in children often results from unicuspid valve morphology. In all paediatric patients with this anomaly, we have performed unicuspid valve repair by bicuspidization, creating a new commissure via adding patch material. This study reviewed our experience with this procedure.

Long-term Outcomes After Pulmonary Endarterectomy in 499 Patients Over a 20-Year Period.

Background: Pulmonary endarterectomy (PEA) is a curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension (PH) after PEA is not uncommon, and its impact on long-term outcomes is poorly understood. We investigated the effects of residual PH on current long-term survival and on postoperative status.

Long-term Results of Differentiated Anatomic Reconstruction of Bicuspid Aortic Valves.

Importance: Bicuspid aortic valve (BAV) repair has been used in limited cohorts, but its long-term results in a large population are unknown.

Objectives: To analyze the long-term stability of BAV repair for survival and the factors associated with repair failure and to evaluate whether a differentiated anatomic repair approach may improve repair stability.

Design, Setting, And Participants: In this case series, 1024 patients underwent BAV repair for aortic regurgitation or aneurysm between October 1995 and June 2018, with a mean (SD) follow-up time of 56 (49) months and maximum follow-up of 271 months.

An Evaluation of the Learning Curve in Pulmonary Endarterectomy Using Propensity Score Matching.

Objective: Pulmonary endarterectomy (PEA) is the only causative, but demanding treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). We analyzed our results with PEA to evaluate the learning curve.

Methods: Consecutive 499 patients who underwent PEA between 1995 and 2014 were divided into two groups according to the temporal order: early cohort ( = 200, December 1995-March 2006), and late cohort ( = 299, March 2006-December 2014).

Mid-term durability of polytetrafluoroethylene patches in unicuspid aortic valve repair.

Objectives: Unicuspid aortic valve (UAV) morphology is a cause for aortic valve dysfunction in childhood or adolescence. Repair requires the use of patch material, and polytetrafluoroethylene (PTFE) has been proposed for this purpose because of lack of calcification. We reviewed our mid-term experience with PTFE for the repair of UAV to analyse the durability of this technique.

Graft Dilatation May Cause Secondary Regurgitation in Aortic Valve-Sparing Operations.

Aortic valve-sparing operations are meant to stabilize the root in order to provide stable aortic valve function. The possibility of graft dilatation has been known in other forms of aortic replacement but is largely ignored in valve-preserving surgery. We describe graft dilatation as a cause of failure late after aortic valve reimplantation.

Reexamining remodelling in children.

Objectives: Some studies have suggested that root remodelling is unsuitable as valve-sparing aortic root replacement in children because of the increased risk of valve failure. This study reviewed our experience with root remodelling in children.

Methods: All patients who underwent root remodelling at the age of ≤18 years between 1999 and 2016 were evaluated.

Bicuspidization and Annuloplasty Provide a Functioning Configuration to the Unicuspid Aortic Valve.

Background: This study reviewed a 12-year experience with a bicuspidization procedure that created a new commissure and added a patch for unicuspid aortic valve repair.

Methods: All patients with a unicuspid aortic valve who underwent bicuspidization with autologous pericardium between 2003 and 2014 were evaluated. The new commissure had initially been created on the rudimentary anterior commissure, and since 2007, symmetric orientation was designed.

Concepts of Bicuspid Aortic Valve Repair: A Review.

Background: The bicuspid aortic valve (BAV) frequently requires surgical intervention for aortic regurgitation (AR) and aneurysm. Valve-preserving surgery for BAV has evolved over the last 25 years.

Methods: This review summarized experience in BAV repair with a special focus on predictors of failure and specific surgical techniques addressing them.

Results of Pericardial Patches in Tricuspid and Bicuspid Aortic Cusp Repair.

Background: Aortic valve repair for aortic regurgitation has become an increasingly accepted alternative to replacement. Some cusp pathologies require partial cusp replacement or augmentation using pericardium. There are limited data on pericardial patch durability.

Bilateral papillary muscle repositioning: successful repair of functional mitral regurgitation in dilative cardiomyopathy.

Objectives: Functional mitral regurgitation (FMR) in patients with non-ischaemic dilative cardiomyopathy (DCM) is associated with heart failure and poor outcome. Aggressively undersized annuloplasty as an annular solution for a ventricular problem ameliorates heart failure but may be associated with recurrent FMR and does not improve survival. We sought to analyse if moderately undersized annuloplasty with repositioning of both papillary muscles can lead to improved valve stability and outcome in patients with DCM and FMR.

Suture Annuloplasty and Simplified Root Wrapping in the Full Root Ross Operation.

This report describes our reinforcement technique for the free-standing autograft in the full root Ross operation, using external suture annuloplasty and simplified root wrapping with native aortic wall. After implantation of the autograft in the aortic annulus, an expanded polytetrafluoroethylene suture is fixed outside the root at the basal plane and tied around a Hegar dilator placed into the autograft. By including the tongues of aortic root tissue at the distal anastomosis of the autograft, three tongues of original root wall lie outside the autograft commissures.

In Vivo Biocompatibility of a Novel Expanded Polytetrafluoroethylene Suture for Annuloplasty.

Background: Expanded polytetrafluoroethylene (ePTFE) is a suture material for annuloplasty in aortic valve repair. For this particular application, it should induce minimal local stress and promote rapid tissue incorporation. To achieve this, a novel ePTFE suture with a larger diameter and high porosity in its midsection has been developed.

Outbreak of complex infections associated with contaminated octenidine mouthwash solution, Germany, August to September 2018.

Three German patients developed nosocomial pneumonia after cardiac surgery and had complex detected in respiratory specimens. Two patients died of septic multi-organ failure. Whole-genome sequencing detected genetically identical complex strains in patient samples, from a batch of octenidine mouthwash solution, which had been used for nursing care, as well as in samples obtained from the manufacturer during production.

Early and long-term outcomes for patients undergoing reoperative aortic root replacement.

Objectives: There are limited data on aortic root replacement (ARR) in patients with previous cardiac surgery. We analysed short-term and long-term results for patients with ARR after previous cardiac surgery.

Methods: From September 1995 to April 2015, 130 patients underwent reoperative ARR.

Echocardiographic criteria to detect unicuspid aortic valve morphology.

Aims: Unicuspid aortic valve (UAV) is a rare congenital malformation associated with severe aortic stenosis or regurgitation. This study aimed to systematically determine echocardiographic criteria to identify UAV.

Methods And Results: All patients underwent a preoperative baseline examination, including echocardiography.

Repair of a Quadricuspid Autograft.

Aortic valve replacement using a pulmonary autograft is an accepted option in children and young patients. The use of a pulmonary valve with congenital anomaly as autograft is controversial. We describe a case in which a quadricuspid pulmonary valve was used as an autograft in childhood.

Cardiac Computed Tomography as an Imaging Modality in Coronary Anomalies.

Coronary artery fistulae and coronary aneurysms are rare anomalies. When they become symptomatic, they require precise anatomic information to allow for planning of the therapeutic procedure. We report a case in which both fistulae and aneurysm were present.