An alternative approach to build a “biologic Bentall” from a pericardial tube and a sutureless valve
This report describes our novel technique to create a bio-Bentall from a pericardial tube and a rapid deployment valve. This technique facilitates the reimplantation of the coronary arteries as the proximal anastomosis is sewn before valve implantation and allows suturing of the coronary ostia from in- and outside as there is no interference with the implanted valve. Indications for this technique can be complex redo cases and patients with contraindications for a conventional Bentall procedure. We have applied this technique in two patients with good results.The Bentall-procedure, first described in 1968 , is the gold standard for patients requiring replacement of the aortic root and valve. Especially in redo cases it can be very difficult to mobilize the coronary buttons and the procedure is accompanied with substantial morbidity and mortality . Various modifications of the original Bentall procedure have been published [3–5]. The novelty of our procedure is implantation of the pericardial tube and anastomosis of the coronary ostia followed by the positioning and implantation of the Intuity Elite rapid deployment valve (Edwards Lifesciences, Irvine CA, USA). This approach minimizes the need for mobilization of the coronary ostia and even allows the implantation of the conduit in an inclusion technique. As the use of the Intuity Elite valve is contraindicated in aneurysms of the aortic root or the ascending aorta this report describes an off-label use.
At a routine follow-up after an aortic valve replacement, a 56-year-old woman complains of fatigue and chest discomfort. What does her ECG show?Medscape Cardiology
ConclusionTAVR is associated with a significant and sustained reduction in all-cause hospitalization in the year following the procedure, when compared to the pre-procedural period.
To describe our endoscopic aortic valve replacement (E-AVR) technique and to evaluate its early results regardless of the type of prosthetic valve implanted and the patients ’ characteristics. From July 2013 to September 2018, 125 patients (76 males, mean age 68.8±10.9 years, mean EuroScore II 1.51±1.39) underwent isolated E-AVR due to a severe stenosis in 99 cases and insufficiency in 26 cases. The surgical access was a 3-4 cm working port in the second right inter costal space with no-rib spreading and three additional 5 mm mini-ports for the introduction of a 30-degree thoracoscope, the Chitwood clamp and the vent line.
Conclusion: The presence of clinically significant TR is associated with an increase in healthcare utilization and expenditures, irrespective of the presence of HF. PMID: 31952454 [PubMed - as supplied by publisher]
This study sought to derive and validate a systematic method enabling AVC quantification using computed tomography angiography (CTA) in patients with AS.Methods134 consecutive patients with AS who underwent both NCCT and CTA were included in the study and sub-divided into derivation (n=71) and validation cohorts (n=63). On NCCT, AVC was quantified using Agatston method utilizing the software developed for semi-automatic assessment of coronary calcium. On CTA, mean contrast attenuation of aorta (AortaHU) and standard deviation (SD) was measured in the region-of-interest at level of sinotubular junction.ResultsUsing an adjus...
CONCLUSIONS: The incidence and risk factor associations for AKI post TAVR vary by definitions used. Decreased GFR at baseline by both MDRD and CKD-EPI and non-transfemoral approach were associated with an increased risk of AKI post TAVR. PMID: 31941833 [PubMed - as supplied by publisher]
This article will review the most common complications described in literature and focuses on the role of multidetector computed tomography (CT) in their evaluation either exclusively, or complementary to other imaging methods.
ConclusionsMinimally invasive reoperative AVR with a sutureless or rapid-deployment prosthesis is a safe and feasible treatment strategy, resulting in fast recovery and improved postoperative outcome with no mortality and an acceptable complication rate.
Publication date: Available online 15 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Yuting Chiang
Evaluate the safety and efficacy of our modified technique of the extravascular procedure for treating mild to moderately dilated ascending aorta in patients with bicuspid aortic valve (BAV) aortopathy.