Aortic valve repair for aortic regurgitation and preoperative echocardiographic assessment

AbstractAortic valvuloplasty (AVP) has been performed less frequently than mitral valvuloplasty. The survival benefit of AVP over replacement has been demonstrated. Therefore, standardization of AVP is crucial for its widespread adoption. The hemodynamic advantage of AVP of preserving the native aortic valve may be one reason for the survival benefit. Recent guidelines still recommend AVP in selected cases compared with the less restricted recommendation for mitral valvuloplasty, although recent studies have proposed earlier indication for surgical intervention. Indication for aortic root replacement is also still conservative, especially in Japan. However, more liberal root replacement should be recommended for better repair when AVP is indicated. Theoretically, all aortic regurgitation lesions can be repaired with acceptable durability. However, restricted cusp should be extended by a pericardial patch, which itself has emerged as a risk of recurrence. Therefore, indications for aortic regurgitation for type III lesions should be determined carefully. Special consideration is crucial for bicuspid aortic valve repair; prevention of postoperative stenosis is especially important. Arrangement of the commissure position is the most important consideration for this purpose, although it remains controversial. Therefore, detailed diagnosis is important in planning AVP, and echocardiography plays a key role in this process.
Source: Journal of Medical Ultrasonics - Category: Radiology Source Type: research

Related Links:

ConclusionsPerforming a concomitant TVP at the time of CF ‐LVAD implantation did not improve patient outcomes but reduced the incidence of 30‐day readmission.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsThis study confirms the safety and efficacy of TMVR with MitraClip irrespective of MR etiology in real-life data and shows the main factors related to prognosis during the first year of follow up.ResumenIntroducción y objetivosLa reparación de la válvula mitral transcatéter (RVMT) con el sistema MitraClip es un tratamiento para los pacientes con insuficiencia mitral (IM) grave de alto riesgo quirúrgico. El objetivo principal fue analizar los resultados del RVMT en pacientes con IM grave, según la etiología.MétodosEstudio observacional, prospectivo y multic&...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
ConclusionsAn increase in diagnostic and therapeutic procedures was reported in 2018, particularly in primary percutaneous coronary interventions. The use of the radial approach and complex procedures also increased. The number of structural procedures rose significantly, following the trend seen in recent years.ResumenIntroducción y objetivosLa Sección de Hemodinámica y Cardiología Intervencionista presenta su informe anual con los datos del registro de actividad correspondiente a 2018.MétodosLos centros españoles con laboratorio de hemodinámica proporcionan sus datos volun...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Aortic valve sparing surgery (AVS), in combination with aortic cusp repair (ACR), still raises many questions about the increased surgical complexity and applicability for patients with pure aortic valve regur...
Source: Journal of Cardiothoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Research article Source Type: research
ConclusionsMinimally invasive surgery of double and triple valve disease is feasible. Our approach through a lateral RmT allows optimal visualization of the aortic, mitral, and tricuspid valves, simplifies the surgical procedure and allows excellent results also in complex MV repair procedures.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionThe standardized modified hemi ‐remodeling technique we present is a safe and reproducible procedure, with satisfactory durability at follow‐up. This technique represents an interesting alternative to full valve sparing root replacement, as it avoids the operative risk of coronary reimplantation, allows shorter cross‐clampi ng time and a better exposition on the valve for a symmetrical repair, placing the commissure at 180°, compared with valve sparing root replacement.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Publication date: Available online 7 November 2019Source: The LancetAuthor(s): Georg Nickenig, Marcel Weber, Philipp Lurz, Ralph Stephan von Bardeleben, Marta Sitges, Paul Sorajja, Jörg Hausleiter, Paolo Denti, Jean-Noël Trochu, Michael Näbauer, Abdellaziz Dahou, Rebecca T HahnSummaryBackgroundTricuspid regurgitation is a prevalent disease associated with high morbidity and mortality, with few treatment options. The aim of the TRILUMINATE trial is to evaluate the safety and effectiveness of TriClip, a minimally invasive transcatheter tricuspid valve repair system, for reducing tricuspid regurgitation.Methods...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionsMIAMVS can be performed via a right mini ‐thoracotomy, with acceptable early and midterm results expected. This may be a feasible alternative to the standard median sternotomy approach.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, pr...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, pr...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
More News: Gastroschisis Repair | Heart Valve Surgery | Japan Health | Radiology | Study