Extra ‐anatomic aortic bypass with aortic‐, mitral‐, and tricuspid surgery in a 53‐year old: A single‐stage approach for complex coarctation associated with triple valve pathology
AbstractCoarctation is rare in patients over 50 years of age; however, if present, it can be associated with complex intracardiac pathologies and represent a formidable surgical challenge. Herein, we report a single ‐stage approach for surgical repair of coarctation associated with aortic, mitral, and tricuspid valve pathology using an ascending‐to‐descending aortic bypass with posterior pericardial access.
ABSTRACTBackgroundLeft atrial (LA) dimension is a marker of disease severity and outcome in primary and secondary mitral regurgitation. In transcatheter mitral valve repair, LA enlargement might additionally impact on device handling and technical success through an altered anatomy and atrial annular dilatation.Methods and resultsData from the multicentre German TRAnscatheter Mitral valve Interventions registry (TRAMI) were used to analyse the association of baseline LA diameter by tertiles with efficacy, safety and long ‐term clinical outcome in patients undergoing edge‐to‐edge repair with MitraClip. In 520 of 843 p...
Mitral regurgitation (MR) can complicate congenital heart disease, particularly when secondary to left ventricular dysfunction and mitral annular dilation. Significant MR is associated with substantial morbidity and mortality in patients with reduced LV systolic function, with recent studies demonstrating that percutaneous mitral valve repair can significantly reduce hospitalizations and all-cause mortality.
Pulmonary Thormboendarterectomy (PTE) has been shown to reduce tricuspid regurgitation. Tricuspid valve repair or replacement (TVR) in addition to the PTE has been used primarily in patients with more severe tricuspid regurgitation (TR), but the effects have not been evaluated.
Mitral regurgitation (MR) is a predictor of poor outcomes in patients with severe left ventricular dysfunction (LV) and options for repairing the valve have yielded conflicting results. We compared one-year echocardiographic and clinical outcomes of patients with grade 3-4MR and severe LV dilatation (end-diastolic dimension [LVEDD] above 65mm) undergoing either left ventricular assist device (LVAD) insertion alone or mitral valve repair (surgical minimally invasive repair or transcatheter edge-to-edge repair).
Significant tricuspid regurgitation (TR) in patients undergoing durable left ventricular assist device (LVAD) implantation has been associated with increased incidence of right heart failure (RHF). There is great surgical practice variability related to moderate TR repair at the time of LVAD implantation. In this single-center study, we investigated whether moderate TR repair concurrent with LVAD implantation has impact on late RHF occurrence.
Significant aortic valve (AV) regurgitation is usually treated with AV replacement (AVR) or AV repair concomitant with left ventricular assist device (LVAD) surgery, as it can cause a closed-loop circulation, leading to a reduced left ventricular unloading and right ventricular (RV) function. However, data regarding survival after these AV procedures is limited. Therefore, the aim of this analysis was to evaluate the clinical outcome after concomitant AVR or AV repair in LVAD patients.
Patients with significant aortic regurgitation at time of left ventricular assist device (LVAD) implantation, frequently need concomitant aortic valve (AV) replacement (AVR) or AV repair. The aim of this study was to investigate the risk for thromboembolic events (TE) in patients with concomitant continuous-flow LVAD and AV surgery.
ConclusionPartial ‐Ross procedure could be used as an alternative for aortic valve repair in children.
Publication date: April 2020Source: JACC: Heart Failure, Volume 8, Issue 4Author(s): Wayne Batchelor, JoAnn Lindenfeld
CONCLUSION: Aneurysm rupture during the waiting time for F/BEVAR can occur but is rare. Patients with a larger aneurysm diameter may be at higher risk of rupture. Measures to reduce the risk of rupture during the waiting time might include the use of off the shelf devices for larger aneurysms, quicker measurement and graft plan order processes, and quicker graft construction and delivery. PMID: 32245614 [PubMed - as supplied by publisher]