Valve-sparing techniques for the treatment of Tetralogy of Fallot with pulmonary stenosis have evolved over the past few decades. This article will discuss the rationale for a more aggressive approach to sparing the pulmonary valve, the various techniques available (including commissurotomy, leaflet thinning and debridement, balloon dilation, and finally modified monocusp repair), as well as a systematic approach for employing these techniques based on individual patient anatomy in a manner that takes full advantages of the benefits of the valve-sparing approach while mitigating the risks involved.
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http://dx.doi.org/10.1053/j.pcsu.2020.02.005 | DOI Listing |
Sultan Qaboos Univ Med J
November 2024
Department of Cardiothoracic Surgery, Royal Hospital, Muscat, Oman.
Objectives: This study primarily aimed to compare the mechanical ventilation durations between pulmonary valve-sparing and transannular patch repair techniques in the surgical correction of Tetralogy of Fallot. Secondary objectives included comparison of demographic characteristics, cardiopulmonary bypass parameters, postoperative vasoactive inotrope requirements, incidence of cardiac conduction abnormalities, echocardiographic findings, intensive care unit and hospitalisation durations, reoperations rates, morbidity and mortality between the 2 approaches.
Methods: This retrospective cohort study was conducted at the Royal Hospital, Muscat, Oman, between January 2016 and December 2019.
J Cardiovasc Dev Dis
November 2024
Department of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, 80336 Munich, Germany.
: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD).
View Article and Find Full Text PDFInnovations (Phila)
December 2024
Division of Cardiac Surgery, Western University, London, ON, Canada.
Aortic root reconstruction operations have undergone substantial evolution with technical modifications, expanding indications, and the need for increasingly complex decision-making. The purpose of this state-of-the-art review is to detail our approach to contemporary aortic root reconstruction operations. First, we review the evolution of root reconstruction procedures over the years and discuss the approach to the aortic root patient for lifetime management of aneurysm and valvular disease in the modern context of management options.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
November 2024
Department of Cardiothoracic Surgery, Hoag Memorial Hospital.
Objective: Re-do root replacement poses a significant technical challenge, increasing potential risk of morbidity and mortality. This multi-institution study compared outcomes in aortic root replacement stratified by chest surgery and aortic root history.
Methods: A retrospective review by the Western Aortic Collaborative was performed for three different aortic centers for patients who underwent non-emergent root replacement from 2017-2023 with exclusion of patients who underwent more than hemiarch replacement or who presented with acute or hyperacute aortic dissection.
Multimed Man Cardiothorac Surg
November 2024
Sana Cardiac Surgery Center Stuttgart, Stuttgart Germany.
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.
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