Purpose: Aortic valve neocuspidization (AVNeo) is a relatively recent advancement in surgical AV replacement. Data on its performance beyond the short term are limited. We assessed the mid-term outcomes in patients undergoing AVNeo, focusing on feasibility, perioperative details, and its role in AV pathology treatment.
Methods: Sixty-five consecutive patients underwent AVNeo between December 2016 and February 2018. Clinical data were prospectively collected and retrospectively analyzed. Tricuspid reconstruction with autologous pericardium was performed in all cases. Echocardiographic follow-up was conducted post-discharge, at 6 and 12 months, and annually thereafter.
Results: The mean age was 62.6 ± 18.7 years. AVNeo was feasible in all cases. Concomitant procedures were performed in 43 (66.2%) patients. Mean bypass and cross-clamp times were 119.2 ± 30.3 and 87.1 ± 22.9 minutes, respectively. Postoperative transvalvular hemodynamics was excellent. There was one (1.5%) in-hospital death. Follow-up (mean 66.72 ± 12.77 months) was complete in 58 patients (89.2%). There were no detected valve-related or thromboembolic events. Transvalvular hemodynamic parameters were stable during the observation period: peak pressure gradient at discharge and follow-up was 15.3 ± 4.6 mmHg and 15.01 ± 6.3 mmHg, respectively (ρ = 0.346).
Conclusions: AVNeo demonstrated the feasibility and favorable mid-term outcomes. Studies with longer-term observation are warranted to evaluate its durability.
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http://dx.doi.org/10.5761/atcs.oa.24-00067 | DOI Listing |
Clin Appl Thromb Hemost
January 2025
Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Percutaneous valve implantation or surgical replacement with mechanical or biological valves are standard therapies for severe valvular heart diseases. Prosthetic valve thrombosis, though rare, is a serious complication, particularly with mechanical prostheses. This study aimed to investigate the predictive value of platelet volume parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for valvular thrombosis risk in patients undergoing valve replacement therapy.
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December 2024
Cardiovascular Surgery, Ayase Heart Hospital, Tokyo, JPN.
Subvalvular aortic stenosis typically manifests at a young age and rarely presents in adulthood. It may cause left ventricular outflow tract stenosis, which requires surgical treatment in severe cases. The coexistence of discrete subvalvular aortic stenosis and quadricuspid aortic valve is a highly unusual finding.
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December 2024
Family Medicine, Louisiana State University Health Sciences Center, Alexandria, USA.
The VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities) association represents an enigmatic syndrome requiring further study. This report describes a full-term neonate born to a multiparous woman who was found, upon further examination, to have multiple congenital abnormalities, including a bicuspid aortic valve, patent foramen ovale, tracheoesophageal fistula (TEF), asymmetric crying facies, microphallus, and a single inguinal testis. The discussion explores environmental and genetic factors that may contribute to this association, as well as similar conditions, such as CHARGE (coloboma, heart defects, choanal atresia, growth retardation, genital abnormalities, and ear abnormalities) syndrome.
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September 2023
Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
The Y incision and roof technique for aortic valve replacement enable implantation of a large prosthetic valve and extensive enlargement of the sinotubular junction. Surgeons have been reluctant to adopt a minimally invasive approach for this procedure because of its complexity and risk. The Stonehenge technique was designed to achieve an ideal surgical view of the aortic root through a small right thoracotomy.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2023
Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Valve-sparing aortic root replacements have acceptable reintervention rates in patients with failed pulmonary autografts after a Ross procedure. In our 50-year-old patient with post-Ross valve-sparing aortic root replacement, we report preoperative and postoperative 4-dimensional flow magnetic resonance imaging capturing changes in peak systolic velocity, 3-dimensional systolic flow profiles, and aortic wall shear stress that may predict a decreased risk of aortic dilation, a common complication in repeated Ross procedures.
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