Valve-sparing reimplantation technique to correct a neo-aortic root/autograft aneurysm after the Ross procedure.

Gradual dilatation of the neo-aortic/pulmonary root or development of an autograft aneurysm and associated valve regurgitation is a major fear and a serious late complication after the Ross procedure to preserve the "principle of a living valve" after the Ross operation by performing the valve-sparing reimplantation technique (David procedure). This article addresses the main peculiarities of this redo scenario compared to a primary/standard David procedure.

The Ross Operation in Young Patients—a Single-Center, Long-Term Follow-Up Study.

Background: The standard aortic valve replacement operations in young patients are bioprosthetic or mechanical aortic valve replacement. In this study, we present the long-term results of the Ross operation in young patients.

Methods: The Ross operation with root replacement was performed on 795 patients between 1995 and 2020.

Double intrathoracic arterial cannulation plus peripheral cannulation for whole-body perfusion in an infant.

We report a technique for distal body perfusion in an infant with hypoplastic aortic arch and isthmus stenosis by ultrasound- guided cannulation of the femoral artery using an intra-arterial vascular sheath establishing whole-body perfusion by triple cannulation.

Triple-Arterial Cannulation Approach for Whole-Body Perfusion in Infant Hypoplastic Aortic Arch and Coarctation Repair.

Organ and end-organ protection in aortic arch surgery represents a substantial challenge, especially in infants. Selective antegrade cerebral perfusion has been reported to improve organ function during this procedure. Visceral perfusion can be optimized by cannulation of the descending aorta during infant aortic arch surgery, leading to a decrease in end organ damage.

The reinforced full-root technique for the Ross operation: surgical considerations and operative insights.

Background: Surgical treatment of young and middle-aged patients suffering from aortic valve disease remains an unresolved issue due to the limited durability of bioprosthetic heart valve replacements and the valve-related morbidity of patients with mechanical valve substitutes. Theoretically, the "living valve" principle of the Ross operation may represent a potentially viable solution to this dilemma. In this paper, we report on the surgical techniques of the Ross procedure and present long-term post-operative outcomes using the reinforced full-root technique.

The zone 2 concept and distal stent graft positioning in TH 2-3 are associated with high rates of secondary aortic interventions in frozen elephant trunk surgery.

Objectives: The goal of this study was to investigate the association between the localization of the distal anastomosis (zone 2/3), the stent graft length (100-160 mm), the position of the distal end of the hybrid prosthesis and the need for secondary aortic intervention (SAI) in acute and chronic thoracic aortic disease after the frozen elephant trunk procedure.

Methods: From 2009 through 2020, a total of 232 patients (137 men; mean age, 61.7 ± 13.

Clinical Outcomes after Mitral Valve Repair with the Physio II Annuloplasty Ring.

Background:  Mitral valve (MV) repair with annuloplasty is the standard of care in patients with primary degenerative mitral regurgitation (DMR). Newer generations of annuloplasty rings have been developed with the goals of closer reproduction of native annular geometry and easier implantation. This study investigates the short-term and 5-year clinical outcomes of MV repair with the Carpentier-Edwards (CE) Physio II annuloplasty ring.

Transcatheter mitral valve repair: review of current techniques.

Mitral regurgitation is common and is associated with excess morbidity and mortality. Despite these poor outcomes, only a minority of affected patients undergo mitral surgery, for several reasons, which underlines the substantial unmet need for treatment for this disorder. Transcatheter mitral valve repair interventions have been developed to treat mitral regurgitation in an undertreated patient population.

Loop neochord versus leaflet resection techniques for minimally invasive mitral valve repair: long-term results.

Objectives: Non-leaflet resection techniques including loop chordal replacement are being used with increasing frequency, but the long-term results of these techniques are still unknown. The aim of this study was to compare the long-term results of loop neochord replacement with leaflet resection techniques in patients undergoing minimally invasive mitral valve (MV) repair for MV prolapse.

Methods: Between 1999 and 2014, 2134 consecutive MV prolapse patients underwent minimally invasive MV repair with isolated loop (n = 1751; 82.

Isolated Mitral Valve Repair in Patients with Reduced Left Ventricular Ejection Fraction.

Purpose: This study aims to analyze the clinical outcomes after isolated mitral valve (MV) repair in patients with reduced left ventricular ejection fraction (LVEF <50%) with focus on perioperative characteristics, survival, and freedom from reoperations.

Methods: Between 1997 and 2015, 557 patients with reduced LVEF (age: 62.8 ± 11.

Annuloplasty ring dehiscence after mitral valve repair: incidence, localization and reoperation.

Objectives: Mitral valve (MV) annuloplasty ring dehiscence with subsequent recurrent mitral regurgitation represents an unusual but challenging clinical problem. Incidence, localization and outcomes for this complication have not been well defined.

Methods: From 1996 to 2016, a total of 3478 patients underwent isolated MV repair with ring annuloplasty at the Leipzig Heart Centre.

Dynamic mitral valve geometry in patients with primary and secondary mitral regurgitation: implications for mitral valve repair†.

Objectives: The goal of this study was to quantify the mitral valve (MV) annulus, the MV shape and the anatomical MV orifice area throughout the cardiac cycle using 4-dimensional MV analysis software in patients with primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR) in comparison to a healthy control group.

Methods: Three-dimensional transoesophageal echocardiograms of the MV were acquired for 29 patients with PMR, for 28 patients with SMR and for 18 healthy control subjects. The MV was quantified with regards to anterior-posterior and lateromedial diameter, annular area and circumference, intertrigonal (IT) distance, annular sphericity index, annular height to commissural width ration, and anatomical MV orifice area throughout the cardiac cycle using 3-dimensional transoesophageal echocardiography-based 4-dimensional MV advanced analysis software.

Changes in dynamic mitral valve geometry during percutaneous edge-edge mitral valve repair with the MitraClip system.

Background: The aim of this study was to quantify the acute dynamic changes of mitral valve (MV) geometry throughout the cardiac cycle-during percutaneous MV repair with the MitraClip system by 3-dimensional transesophageal echocardiography (3D TEE).

Methods: The MV was imaged throughout the cardiac cycle (CC) before and after the MitraClip procedure using 3D TEE in 28 patients (mean age, 77 ± 8 years) with functional mitral regurgitation (FMR). Dynamic changes in the MV annulus geometry and anatomical MV orifice area (AMVOA) were quantified using a novel semi-automated software.

Clinical pearl: Mohs cantaloupe analogy for the dermatology resident.

Mohs micrographic surgery (MMS) is a challenging procedure to conceptualize, yet it is an integral component of dermatology residency. The cantaloupe analogy is a tool that can be used to assist in visualizing MMS specimen processing, which transitions the 3-dimensional multilayered skin to a 2-dimensional histologic slide.

Acute Effect of Mitral Valve Repair on Mitral Valve Geometry.

Background:  The aim of this study was to quantify acute mitral valve (MV) geometry dynamic changes throughout the cardiac cycle using three-dimensional transesophageal echocardiography (3D TEE) in patients undergoing surgical MV repair (MVR) with ring annuloplasty and optional neochord implantation.

Methods:  Twenty-nine patients (63 ± 10 years) with severe primary mitral regurgitation underwent surgical MVR using ring annuloplasty with or without neochord implantation. We recorded 3D TEE data throughout the cardiac cycle before and after MVR.

Advances in Mitral Valve Surgery.

Mitral valve (MV) insufficiency, classified as primary and secondary mitral regurgitation (MR), is a common cause of morbidity and mortality. In industrialized countries, degenerative forms are the predominant cause of MR; however, an increasing number of patients present with secondary MR (Iung et al. EHJ 24:1231-1243, 2003).

Combined Mitral and Tricuspid Versus Isolated Mitral Valve Transcatheter Edge-to-Edge Repair in Patients With Symptomatic Valve Regurgitation at High Surgical Risk.

Objectives: The present study aimed to test the clinical benefit of combined transcatheter mitral plus tricuspid valve edge-to-edge repair (TMTVR) as compared with transcatheter mitral valve edge-to-edge repair (TMVR) alone in patients with both significant mitral (MR) and tricuspid regurgitation (TR) at high surgical risk.

Background: A growing number of patients with severe MR at increased surgical risk are treated by transcatheter techniques. Evidence suggests that residual TR remains a predictor of adverse outcome in these patients.

Good 5-Year Durability of Transapical Beating Heart Off-Pump Mitral Valve Repair With Neochordae.

Background: Transapical, beating heart, off-pump implantation of neochordae for repair of mitral valve (MV) prolapse is of increasing interest. The aim of this study was to evaluate long term results for MV repair using the NeoChord system (NeoChord, St. Louis Park, MN).

Transcatheter treatment of tricuspid regurgitation using edge-to-edge repair: procedural results, clinical implications and predictors of success.

Aims: The aim of this study was to analyse the feasibility, safety and effectiveness of tricuspid valve (TV) repair using the MitraClip system in patients at high surgical risk.

Methods And Results: Forty-two elderly high-risk patients (76.8±7.

Complex cases of acquired pulmonary vein stenosis after radiofrequency ablation: is surgical repair an option?

Aims: Results of catheter based interventional treatment for pulmonary vein stenosis (PVS) following radiofrequency ablation (RFA) for atrial fibrillation remain suboptimal. Surgical repair may represent an alternative therapy, though long-term results have not been thoroughly investigated.

Methods And Results: We retrospectively assessed all patients in our centre undergoing surgical repair for radiofrequency-induced PVS.

Six-month outcome after transcatheter edge-to-edge repair of severe tricuspid regurgitation in patients with heart failure.

Aims: Severe tricuspid regurgitation (TR) is common in patients with right-sided heart failure (HF) and causes substantial morbidity and mortality. Treatment options beyond medical therapy are limited for high-risk patients. Transcatheter edge-to-edge tricuspid valve (TV) repair showed procedural safety and short-term efficacy.

Mitral valve repair: Robotic and other minimally invasive approaches.

Robotic and minimally invasive mitral valve (MV) procedures have been performed with increasing frequency over time. These alternatives offer similar efficacy to that achieved via standard median sternotomy, particularly in large volume centers, along with low perioperative morbidity and mortality rates. Moreover, patient acceptance is oftentimes increased due to less postoperative pain and shorter recovery times, as well as superior cosmetic results.