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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 617-621, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association


ARTICLES

An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta

TE David and CM Feindel
Division of Cardiovascular Surgery, University of Toronto, Ontario, Canada.

A number of patients who require an operation for complications of annuloaortic ectasia, such as aortic incompetence or aneurysm of the aortic root (or both), have normal aortic valve leaflets. We have treated these patients by excising the aneurysmal portion of the ascending aorta and sinuses of Valsalva but by leaving the aortic valve leaflets and some arterial wall attached to the left ventricular outflow tract. The aortic valve is reimplanted inside a collagen- impregnated tubular Dacron graft, similar to what is done for implantation of an aortic valve homograft. The coronary arteries are also reimplanted. This operation was performed in 10 patients. All patients had annuloaortic ectasia and five had the stigmata of Marfan syndrome. Four patients had acute aortic dissection. There were no operative deaths, but one patient required composite replacement of the aortic valve and ascending aorta because of persistent aortic incompetence. Postoperative Doppler echocardiography revealed normal aortic valve function in six patients and mild incompetence in three. The preliminary results of this new operation are encouraging. Further investigation is necessary to establish the best size, shape, and type of material that should be used to replace the aortic root while preserving the aortic valve.


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Ann. Thorac. Surg.Home page
D. Richardt, A. Karluss, C. Schmidtke, H.-H. Sievers, and M. Scharfschwerdt
A New Sinus Prosthesis for Aortic Valve-Sparing Surgery Maintaining the Shape of the Root at Systemic Pressure
Ann. Thorac. Surg., March 1, 2010; 89(3): 943 - 946.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
F. Kerendi, R. A. Guyton, J. D. Vega, P. D. Kilgo, and E. P. Chen
Early Results of Valve-Sparing Aortic Root Replacement in High-Risk Clinical Scenarios
Ann. Thorac. Surg., February 1, 2010; 89(2): 471 - 478.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. Forteza, J. De Diego, J. Centeno, M. J. Lopez, E. Perez, C. Martin, V. Sanchez, J. J. Rufilanchas, and J. Cortina
Aortic Valve-Sparing in 37 Patients With Marfan Syndrome: Midterm Results With David Operation
Ann. Thorac. Surg., January 1, 2010; 89(1): 93 - 96.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
P. P. Urbanski
Basal cusp enlargement for repair of aortic valve insufficiency
J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 98 - 102.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. Sauer, M. A. Borger, J. Seeburger, and F. W. Mohr
Successful Surgical Treatment of Atrial Fibrillation, Mitral Regurgitation, and Aortic Root Aneurysm in a Patient With Classical Type Ehlers-Danlos Syndrome
Ann. Thorac. Surg., January 1, 2010; 89(1): 273 - 275.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
D. Aicher, R. Fries, S. Rodionycheva, K. Schmidt, F. Langer, and H.-J. Schafers
Aortic valve repair leads to a low incidence of valve-related complications
Eur J Cardiothorac Surg, January 1, 2010; 37(1): 127 - 132.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
F. Bakhtiary, N. Monsefi, M. Trendafilow, T. Wittlinger, M. Doss, and A. Moritz
Modification of the David Procedure for Reconstruction of Incompetent Bicuspid Aortic Valves
Ann. Thorac. Surg., December 1, 2009; 88(6): 2047 - 2049.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
T. E. David, S. Armstrong, M. Maganti, J. Colman, and T. J. Bradley
Long-term results of aortic valve-sparing operations in patients with Marfan syndrome.
J. Thorac. Cardiovasc. Surg., October 1, 2009; 138(4): 859 - 864.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
E. Lansac, I. Di Centa, F. Raoux, N. Bulman-Fleming, A. Ranga, A. Abed, M. Ba, A. Paolitto, D. Letourneur, and A. Meddahi-Pelle
An expansible aortic ring for a physiological approach to conservative aortic valve surgery
J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 718 - 724.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. M. Sheikh and T. E. David
Aortic Valve-Sparing Operations: Dealing With the Coronary Artery That is Too Close to the Aortic Annulus
Ann. Thorac. Surg., September 1, 2009; 88(3): 1026 - 1028.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
N. Khaladj, I. Ismail, M. Shrestha, S. Peterss, M. Pichlmaier, K. Kallenbach, A. Haverich, and C. Hagl
Aortic root surgery in combination with hypothermic circulatory arrest: preserve or replace the aortic valve in the context of postoperative neurological outcome? A case match comparison
Interact CardioVasc Thorac Surg, August 1, 2009; 9(2): 246 - 250.
[Abstract] [Full Text] [PDF]


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Asian Cardiovascular and Thoracic AnnalsHome page
H. Izumoto, K. Kawazoe, T. Oka, K. Ishibashi, H. Yamamoto, and F. Yamamoto
Leaflet Suspension and Subvalvular Annuloplasty in Aortic Valve Prolapse
Asian Cardiovascular and Thoracic Annals, June 1, 2009; 17(3): 278 - 281.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
A. C. Kollar, S. D. Lick, and V. R. Conti
Valve-Sparing Aortic Root Reconstruction Using In Situ Three-Dimensional Measurements
Ann. Thorac. Surg., June 1, 2009; 87(6): 1795 - 1800.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
S. D. Barnett and N. Ad
Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005
J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1422 - 1429.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
D. E. Cameron, D. E. Alejo, N. D. Patel, L. U. Nwakanma, E. S. Weiss, L. A. Vricella, H. C. Dietz, P. J. Spevak, J. A. Williams, B. T. Bethea, et al.
Aortic Root Replacement in 372 Marfan Patients: Evolution of Operative Repair Over 30 Years
Ann. Thorac. Surg., May 1, 2009; 87(5): 1344 - 1350.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
I. V. Volguina, D. C. Miller, S. A. LeMaire, L. C. Palmero, X. L. Wang, H. M. Connolly, T. M. Sundt III, J. E. Bavaria, H. C. Dietz, D. M. Milewicz, et al.
Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: Analysis of early outcome.
J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1124 - 1132.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
M. Boodhwani, L. de Kerchove, and G. El Khoury
Aortic root replacement using the reimplantation technique: tips and tricks
Interact CardioVasc Thorac Surg, May 1, 2009; 8(5): 584 - 586.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
L. A. Bockeria, A. I. Malashenkov, and S. V. Rychin
eComment: Aortic root replacement using the reimplantation technique: tips and tricks
Interact CardioVasc Thorac Surg, May 1, 2009; 8(5): 586 - 586.
[Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
I. V. Volguina, D. C. Miller, S. A. LeMaire, L. C. Palmero, X. L. Wang, H. M. Connolly, T. M. Sundt III, J. E. Bavaria, H. C. Dietz, D. M. Milewicz, et al.
Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: analysis of early outcome.
J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 641 - 649.
[Abstract] [Full Text] [PDF]


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Asian Cardiovascular and Thoracic AnnalsHome page
M. Shrestha, N. Khaladj, C. Hagl, and A. Haverich
Valve-Sparing Aortic Root Stabilization in Acute Type a Aortic Dissection
Asian Cardiovascular and Thoracic Annals, February 1, 2009; 17(1): 22 - 24.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
M. Boodhwani, L. de Kerchove, D. Glineur, A. Poncelet, J. Rubay, P. Astarci, R. Verhelst, P. Noirhomme, and G. El Khoury
Repair-oriented classification of aortic insufficiency: Impact on surgical techniques and clinical outcomes.
J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 286 - 294.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
T. Hanke, E. I. Charitos, U. Stierle, D. Robinson, A. Gorski, H.-H. Sievers, and M. Misfeld
Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery
J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 314 - 319.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
G. Ruvolo and K. Fattouch
Aortic valve-sparing root replacement from inside the aorta using three Dacron skirts preserving the native Valsalva sinuses geometry and stabilizing the annulus
Interact CardioVasc Thorac Surg, February 1, 2009; 8(2): 179 - 181.
[Abstract] [Full Text] [PDF]


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Interact CardioVasc Thorac SurgHome page
P. P. Urbanski, X. Zhan, S. Frank, and A. Diegeler
Aortic root reconstruction using new vascular graft
Interact CardioVasc Thorac Surg, February 1, 2009; 8(2): 187 - 190.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
F. Roubertie, W. B. Ali, O. Raisky, D. Tamisier, D. Sidi, and P. R. Vouhe
Aortic root replacement in children: a word of caution about valve-sparing procedures
Eur J Cardiothorac Surg, January 1, 2009; 35(1): 136 - 140.
[Abstract] [Full Text] [PDF]


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MMCTSHome page
M. Boodhwani, L. de Kerchove, D. Glineur, P. Noirhomme, and G. El Khoury
Repair of aortic valve cusp prolapse
MMCTS, January 1, 2009; 2009(0702): mmcts.2008.003806 - mmcts.2008.003806.
[Abstract] [Full Text] [PDF]




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