A novel method for reconstructing the sinus and annulus for the treatment of annuloaortic ectasia Takeshi Shimamoto, MD, Akira Marui, MD, PhD, Takeshi.

Slides:

Advertisements

Similar presentations

Bicuspid aortic valve repair by complete conversion from “raphe'd” (type 1) to “symmetric” (type 0) morphology Thomas G. Gleason, MD The Journal of.

Advertisements

Translocation of a single coronary artery from the nonfacing sinus in the arterial switch operation: Long-term patency of the interposition graft Igor.

Valve-Sparing Aortic Root Replacement

Aortic Valve Reconstruction With Leaflet Replacement and Sinotubular Junction Fixation: Early and Midterm Results Meong Gun Song, MD, Hyun Suk Yang,

Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension Christian A. Bermudez, MD,

Aortic Valve Replacement with Pulmonary Autograft: Subcoronary and Aortic Root Inclusion Techniques Tirone E. David, MD Operative Techniques in Thoracic.

J. Scott Rankin, MD, M. Crockett Bone, BS, Peter M

Operative Techniques in Thoracic and Cardiovascular Surgery

Aortic valve–sparing reimplantation for dilatation of the ascending aorta and aortic regurgitation late after repair of congenital heart disease Masamichi.

Toward more reliable repair of ruptured sinus of Valsalva

Mitral annuloplasty in an infant with Barth syndrome and severe mitral insufficiency: First case report and determination of annular diameter Shu-Chien.

Minimally invasive transapical aortic valve-in-a-valve implantation for severe aortic regurgitation in a degenerated stentless bioprosthesis Timotheos.

Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.

Orientation of bileaflet mechanical aortic valve prostheses for optimal evaluation by transthoracic echocardiography Alberto Bouzas-Mosquera, MD, PhD,

Basal cusp enlargement for repair of aortic valve insufficiency

Chun Wang, MD, Zongyi Xiu, MD, Tianxiang Gu, MD

Ruptured sinus of Valsalva aneurysm: Transaortic repair may cause sinus of Valsalva distortion and aortic regurgitation Sung-Ho Jung, MD, Tae-Jin Yun,

Huge aneurysms of the aortic sinuses of Valsalva with leaflet perforation in an infant: A case report Atsushi Kawaguchi, MD, Kenji Waki, MD, Yoshio Arakaki,

An alternate approach to valve replacement in patients with mitral stenosis and severely calcified annulus Sameh M. Said, MD, Hartzell V. Schaff, MD

A novel approach to prevent spinal cord ischemia: Inoue stent graft with a side branch of small caliber for the reconstruction of the artery of Adamkiewicz

A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium Shigeyuki Ozaki, MD, PhD, Isamu Kawase, MD, Hiromasa.

The TachoSil-Pledget Stitch: Towards Eradication of Suture Hole Bleeding Takeshi Shimamoto, MD, Akira Marui, MD, PhD, Takeshi Nishina, MD, PhD, Yoshiaki.

Takeshi Shimamoto, MD, Tatsuhiko Komiya, MD, Genichi Sakaguchi, MD

Remodeling the Aortic Root and Preservation of the Native Aortic Valve

John S. Ikonomidis, MD, PhD, FRCS(C), Abe DeAnda, MD, D

Valve-sparing aortic root repair without down-sizing of the annulus

Cardiovascular operations for Loeys-Dietz syndrome: Intermediate-term results Nishant D. Patel, MD, Todd Crawford, MD, J. Trent Magruder, MD, Diane E.

Hassane Abdallah, MD, Alaae Boutayeb, MD, Gebrine El Khoury, PhD

An intraoperative test device for aortic valve repair

Paul Modi, FRCS, Ansar Hassan, MD, PhD, W. Randolph Chitwood, MD

Intra-atrial rerouting by the posterior left atrial wall flap for total anomalous pulmonary venous return drainage into the coronary sinus in neonates

Dilated cardiomyopathy and functional mitral regurgitation complicated with traumatic ventricular septal defect Hisato Ito, MD, Kiyohito Yamamoto, MD,

Impact of left atrial volume reduction concomitant with atrial fibrillation surgery on left atrial geometry and mechanical function Akira Marui, MD,

Jong Hun Kim, MD, Jong Bum Choi, MD

Valve-sparing root repair: V-shaped remodeling can be performed in all sinuses Paul P. Urbanski, MD, PhD The Journal of Thoracic and Cardiovascular Surgery

Causes and management of aortic valve regurgitation after aortic valve reimplantation Christian Giebels, MD, Diana Aicher, MD, Takashi Kunihara, MD, PhD,

Aortic root morphology in patients undergoing percutaneous aortic valve replacement: Evidence of aortic root remodeling Mateen Akhtar, MD, E. Murat Tuzcu,

Successful repair of a variant of mitral arcade

Novel Technique of Valve-Sparing Aortic Root Replacement in Two Children Younger Than 3 Years of Age James K. Kirklin, MD, Walter H. Johnson, MD, Barton.

Results of Aortic Valve-Sparing and Restoration With Autologous Pericardial Leaflet Extensions in Congenital Heart Disease Jonah Odim, MD, PhD, MBA,

The cone reconstruction of the tricuspid valve in Ebstein’s anomaly

Maher N. Abadeer, MD, Peter C. Kouretas, MD, PhD, Ronald K

Quick but effective surgery for functional mitral regurgitation secondary to aortic valve disease Masashi Komeda, MD, PhD The Journal of Thoracic and.

Truly stentless autologous pericardial aortic valve replacement: An alternative to standard aortic valve replacement K.M. John Chan, BMedSci (Hons),

Chordal cutting technique through aortotomy: A new approach to treat chronic ischemic mitral regurgitation Georges Fayad, MD, Thomas Modine, MD, Thierry.

Intermediate-term results of a nonresectional dynamic repair technique in 662 patients with mitral valve prolapse and mitral regurgitation Gerald M.

Repair follows anatomy

Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of valsalva, and ventricular septal defect Magdi.

Reoperative innominate arterial, ascending aortic, and root replacement for extensive fungal endocarditis Bradley G. Leshnower, MD, Thomas G. Gleason,

Patrick O. Myers, MD, Yacine Aggoun, MD, Cecile Tissot, MD

Anatomic repair of Ebstein's anomaly with isolated anterior leaflet downward displacement Qingyu Wu, MD, Guangyu Pan, MD, Hongyin Li, MD, Xiangchen Kong,

Acute myocardial infarction and limb ischemia as manifestation of nonbacterial thrombotic endocarditis Naoko Nagano, MD, Jean-François Morin, MD, FRCS,

Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets Shinji Masuyama, MD, Akira.

A novel atrial volume reduction technique to enhance the Cox maze procedure: Initial results Akira Marui, MD, PhD, Takeshi Nishina, MD, PhD, Keiichi.

Anna Marciniak, PhD, Georgios T

Aortic valve repair by sinotubular junctional remodeling to eliminate aortic regurgitation in donor cardiac allograft David J. Kaczorowski, MD, Y. Joseph.

Luca A. Vricella, MD, Duke E. Cameron, MD

Which is the “lord” of the aortic rings?

Double-Root Translocation for Double-Outlet Right Ventricle With Noncommitted Ventricular Septal Defect or Double-Outlet Right Ventricle With Subpulmonary.

An acutely angled high takeoff left main coronary artery in an aortic root and proximal arch aneurysm Kyung Hwa Kim, MD, PhD The Journal of Thoracic.

Advantages of the continuous telescopic inversion technique do not overcome the disadvantages of the “turn-up” technique of aortic anastomosis Takeshi.

Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children Gang Zhang, MD, Fusheng Zhang, MD, Mei Zhu,

Preserving the V-engine shape of the left ventricle with Melody mitral valve replacement in small children Patrick O. Myers, MD The Journal of Thoracic.

Homograft valve repair for recurrent prosthetic valve endocarditis

Long-Term Results of Aortomitral Fibrous Body Reconstruction With Double-Valve Replacement Su Wan Kim, MD, Pyo Won Park, MD, PhD, Wook Sung Kim, MD,

Aneurysmal right coronary with fistula to the coronary sinus combined with severe stenosis of the left anterior descending artery: A snake on the heart

Remodeling of the aortic root and reconstruction of the bicuspid aortic valve Hans-Joachim Schäfers, MD, PhD, Frank Langer, MD, Diana Aicher, MD, Thomas.

Echo-free perfused spaces: A current postoperative finding after homograft replacement of the aortic valve T. Carrel, MD, M. Pasic, MD, E. Oechslin,

The papillary muscle sling for ischemic mitral regurgitation

Designing valves: An art or science?

Presentation transcript:

A novel method for reconstructing the sinus and annulus for the treatment of annuloaortic ectasia Takeshi Shimamoto, MD, Akira Marui, MD, PhD, Takeshi Nishina, MD, PhD, Yoshiaki Saji, MD, Masashi Komeda, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 138, Issue 5, Pages 1244-1246 (November 2009) DOI: 10.1016/j.jtcvs.2008.09.009 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Preoperative (A) and postoperative (B) echocardiograms in an apical long-axis view showing that preoperative severe aortic regurgitation (asterisk in A) was significantly reduced to mild aortic regurgitation (asterisk in B) and that the preoperative root dilation (arrow in A) was reduced postoperatively (arrow in B). LV, Left ventricle; LA, left atrium; Ao, ascending aorta. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1244-1246DOI: (10.1016/j.jtcvs.2008.09.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Preoperative (A) and postoperative (B) schematic presentation of the aortic root in the transaortic view. A, Marked dilatation (large arrows) and downward dislocation (small arrows) of the right and noncoronary annuluses were noticed preoperatively. The morphology of each aortic leaflet appeared near normal, and 3 commissures were of normal height. The lengths of the corresponding edges of the 3 leaflets appeared almost equivalent. B, The left coronary sinus was used as a reference because it had a normal appearance. Its length between the annulus and the coronary orifice, the annulus, and the corresponding circumferential length at the sinotubular junction were measured with silk sutures and a ruler. A bovine pericardial patch was individually scalloped according to the aforementioned measurements. The opening was tailored at the corresponding zone for the right coronary orifice. The patches were sutured to the annulus with pledgeted 5-0 polypropylene sutures, passing from the left ventricular side; this uplifted (small dotted arrows) and reduced the size of (large dotted arrows) the annulus, leading to improved leaflet coaptation. The right coronary orifice was secured to the opening of the patch with 6-0 polypropylene sutures. The curves of the patches were then anastomosed along the neighboring commissures up to the level of the sinotubular junction with 5-0 polypropylene sutures to uplift and plicate the aortic annulus, such that the shapes of all reconstructed sinuses were symmetric. Finally, the dilated sinotubular junction and the upper portion of the patch were anastomosed to the Dacron graft, thus achieving a reduction in the size of the sinotubular junction (circled dotted arrow). R, Right coronary sinus; N, noncoronary sinus; L, left coronary sinus; P, tongue-shaped bovine pericardial patch. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1244-1246DOI: (10.1016/j.jtcvs.2008.09.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions