HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Tirone E. David Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Krasopoulos, G. Articles by Armstrong, S. Search for Related Content PubMed Articles by Krasopoulos, G. Articles by Armstrong, S. Related Collections Valve disease

J Thorac Cardiovasc Surg 2008;135:3-7
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Custom-tailored valved conduit for complex aortic root disease

Division of Cardiovascular Surgery of Peter Munk Cardiac Centre at University Health Network, Toronto, Ontario, Canada.

Received for publication February 1, 2007; revisions received May 30, 2007; accepted for publication June 11, 2007.

^_* Address for reprints: Tirone E. David, MD, 200 Elizabeth St, 4N457, Toronto, Ontario, Canada M5G 2C4. (Email: tirone.david{at}uhn.on.ca).

Objectives: Commercially available conduits containing a valve are not always suitable for simultaneous reconstruction of the left ventricular outflow tract and replacement of the aortic root. We describe our experience with custom-made conduits for patients with complex disease of the aortoventricular junction.

Methods: Twenty-seven patients with a destroyed aortoventricular junction resulting from endocarditis and/or multiple previous operations had reconstruction of the left ventricular outflow tract with a tailored tubular Dacron graft. The graft was tailored to correct the defect in the outflow tract and sutured with continuous polypropylene sutures directly to the interventricular septum and the intervalvular fibrous body or sewing ring of a prosthetic mitral valve. The coronary arteries were reimplanted as high as anatomically possible and a mechanical (16 patients) or bioprosthetic valve (11 patients) was implanted into the graft below the coronary arteries. Median age of the patients was 55 years. The follow-up was complete, with echocardiographic studies and a median period of 32 months.

Results: There were 3 operative and no late deaths. One patient required early reoperation for dehiscence of a patch used to reconstruct the posterior mitral valve annulus. Twenty-four patients were alive at the last follow-up and had a normally functioning aortic valve prosthesis and no false aneurysms.

Conclusion: Intraoperatively tailored tubular Dacron graft for concomitant reconstruction of the left ventricular outflow tract and replacement of the aortic root is a useful and safe operative technique for patients with destroyed aortoventricular junction.

This article has been cited by other articles:

				T. E. David, S. Armstrong, M. Maganti, and L. Ihlberg Clinical outcomes of combined aortic root replacement with mitral valve surgery J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 82 - 87. [Abstract] [Full Text] [PDF]