Presentation is loading. Please wait.

Presentation is loading. Please wait.

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

Published byGuus Hermans Modified over 5 years ago

Similar presentations

Presentation on theme: "Results of Aortic Valve-Sparing and Restoration With Autologous Pericardial Leaflet Extensions in Congenital Heart Disease  Jonah Odim, MD, PhD, MBA,"— Presentation transcript:

1 Results of Aortic Valve-Sparing and Restoration With Autologous Pericardial Leaflet Extensions in Congenital Heart Disease  Jonah Odim, MD, PhD, MBA, Hillel Laks, MD, Vivek Allada, MD, John Child, MD, Stacy Wilson, BS, David Gjertson, PhD  The Annals of Thoracic Surgery  Volume 80, Issue 2, Pages (August 2005) DOI: /j.athoracsur Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Conversion of bicuspid aortic valve to tricuspid configuration and cusp augmentation with autologous pericardial leaflet extensions. The median raphe of the conjoined cusp is incised from the free edge up to the annulus. The fibrotic, stiff, and rolled-up free edges are thinned back to pliable tissue. Glutaraldehyde-treated autologous pericardial extensions are sewn to the native free-edges with a running polypropylene suture up to the aortic wall. The suture line is continued up the aortic wall (full thickness) to just below the sinotubular junction. The pericardial leaflet extensions are secured to one another over a pericardial pledget on the outside of the aorta. This creates neo-commissures just below the sinotubular junction (bold arrows at top) and a taller interleaflet triangle creating optimal zone of coaptation. The hinge point of the valve (arrows below) remains in the pliable native cusp remnant ensuring flexibility and valve function in the event of leaflet extension fibrosis or calcification. Dilated and aneurysmal sinuses of valsalva are excluded from the remodeled aortic root with glutaraldehyde-treated pericardial lining. It is typical for relative dilation of the noncoronary sinus; however with connective tissue disorders all three sinuses may be involved and are excluded with pericardial lining to prevent further dilation, rupture, or dissection. Sinuses harboring coronary arteries require pericardial button removal overlying the ostia. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Fusion of noncoronary and right coronary cusps to form conjoined leaflet with doming of the bicuspid aortic valve (upper panel). Trileaflet valve conversion with autologous pericardial leaflet extensions with classic “Mercedes Benz” sign in cross-section and resolution of valve doming (lower panel). (ASC. AORTA = ascending aorta; LA = left atrium; LCA = left coronary artery; LV = left ventricle; RA = right atrium.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Freedom from valve-related reoperation. (AVR = aortic valve repair; CHD = congenital heart disease; post-OP = postoperative.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Freedom from valve-related reoperation after repair (age, < 19 years). (AVR = aortic valve repair; post-OP = postoperative.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Impact or restoration of trileaflet semilunar configuration. (AVR = aortic valve repair; post-OP = postoperative.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

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

Similar presentations

Late Surgical Explantation and Aortic Valve Replacement After Transcatheter Aortic Valve Implantation  Louis W. Wang, MBBS, MM, Emily K. Granger, MBBS,

Late Surgical Explantation and Aortic Valve Replacement After Transcatheter Aortic Valve Implantation  Louis W. Wang, MBBS, MM, Emily K. Granger, MBBS,
Hans-H. Sievers, MD, Claudia Schmidtke, MD, MBA 

Hans-H. Sievers, MD, Claudia Schmidtke, MD, MBA 
The Completion Bentall Procedure

The Completion Bentall Procedure
Edward H. Kincaid, MD, Neal D. Kon, MD 

Edward H. Kincaid, MD, Neal D. Kon, MD 
Surgical Correction of Congenital Supravalvular Aortic Stenosis

Surgical Correction of Congenital Supravalvular Aortic Stenosis
Long-Term Experience of Girdling the Ascending Aorta With Dacron Mesh as Definitive Treatment for Aneurysmal Dilation  Oved Cohen, MD, Jonah Odim, MD,

Long-Term Experience of Girdling the Ascending Aorta With Dacron Mesh as Definitive Treatment for Aneurysmal Dilation  Oved Cohen, MD, Jonah Odim, MD,
Successful Repair of Regurgitant Pentacuspid Pulmonary Valve Combined With Pulmonary Artery Aneurysm  Tasuku Kadowaki, MD, Hiroki Yamaguchi, MD, PhD,

Successful Repair of Regurgitant Pentacuspid Pulmonary Valve Combined With Pulmonary Artery Aneurysm  Tasuku Kadowaki, MD, Hiroki Yamaguchi, MD, PhD,
Surgical and Pathological Anatomy of the Aortic Valve and Root

Surgical and Pathological Anatomy of the Aortic Valve and Root
Toward more reliable repair of ruptured sinus of Valsalva

Toward more reliable repair of ruptured sinus of Valsalva
Complete Atrioventricular Canal: Comparison of Modified Single-Patch Technique With Two-Patch Technique  Carl L. Backer, MD, Robert D. Stewart, MD, Frédérique.

Complete Atrioventricular Canal: Comparison of Modified Single-Patch Technique With Two-Patch Technique  Carl L. Backer, MD, Robert D. Stewart, MD, Frédérique.
Basal cusp enlargement for repair of aortic valve insufficiency

Basal cusp enlargement for repair of aortic valve insufficiency
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,

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,
Surgical Anatomy of the Aortic Annulus: Landmarks for External Annuloplasty in Aortic Valve Repair  Nizar Khelil, MD, Ghassan Sleilaty, MD, Michele Palladino,

Surgical Anatomy of the Aortic Annulus: Landmarks for External Annuloplasty in Aortic Valve Repair  Nizar Khelil, MD, Ghassan Sleilaty, MD, Michele Palladino,
A Novel Technique of Aortic Root Reconstruction for Extensive Endocarditis: The Pericardial Skirt Technique  Kiyoshi Doi, MD, PhD, Suguru Ohira, MD, Masahiro.

A Novel Technique of Aortic Root Reconstruction for Extensive Endocarditis: The Pericardial Skirt Technique  Kiyoshi Doi, MD, PhD, Suguru Ohira, MD, Masahiro.
Remodeling the Aortic Root and Preservation of the Native Aortic Valve

Remodeling the Aortic Root and Preservation of the Native Aortic Valve
New Technique of Aortic Root Reconstruction With Aortic Valve Annuloplasty in Ascending Aortic Aneurysm  Akhtar Rama, MD, Sylvain Rubin, MD, Nicolas Bonnet,

New Technique of Aortic Root Reconstruction With Aortic Valve Annuloplasty in Ascending Aortic Aneurysm  Akhtar Rama, MD, Sylvain Rubin, MD, Nicolas Bonnet,
Successful aortic root remodeling for repair of a dilated pulmonary autograft after a ross- Konno procedure in early childhood  Shintaro Nemoto, MD, PhD,

Successful aortic root remodeling for repair of a dilated pulmonary autograft after a ross- Konno procedure in early childhood  Shintaro Nemoto, MD, PhD,
Dennis M. Mello, MD, John Fahey, MD, Gary S. Kopf, MD 

Dennis M. Mello, MD, John Fahey, MD, Gary S. Kopf, MD 
G. Chad Hughes, MD, Madhav Swaminathan, MD, Walter G. Wolfe, MD 

G. Chad Hughes, MD, Madhav Swaminathan, MD, Walter G. Wolfe, MD 
Transposition of the Great Arteries and Quadricuspid Pulmonary Valve: An Unusual Combination  Marco Ricci, MD, Gordon A. Cohen, MD, PhD, Ergin Kocyildirim,

Transposition of the Great Arteries and Quadricuspid Pulmonary Valve: An Unusual Combination  Marco Ricci, MD, Gordon A. Cohen, MD, PhD, Ergin Kocyildirim,

Similar presentations

Ads by Google