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Neo-Leaflet Failure after Comprehensive Aortic Root and Valve Reconstruction.

Park SJ, Lee JW, Chung CH - Korean J Thorac Cardiovasc Surg (2015)

Bottom Line: The comprehensive aortic root and valve reconstruction (CARVAR) technique comprises two main procedures, which are aortic root reduction using prosthetic rings and neo-leaflet reconstruction using a pericardial patch.After resecting the reconstructed leaflets, aortic valve replacement was performed in the patients.Careful and close follow-up is required for patients who had undergone CARVAR surgery, and aortic valve surgery should be performed in a timely manner if needed.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.

ABSTRACT
The comprehensive aortic root and valve reconstruction (CARVAR) technique comprises two main procedures, which are aortic root reduction using prosthetic rings and neo-leaflet reconstruction using a pericardial patch. Although concerns about durability of the pericardial neo-leaflet have been raised in the CARVAR technique, complications related to leaflet reconstruction have not been reported to date. The present report describes two cases of complications associated with leaflet reconstruction. After resecting the reconstructed leaflets, aortic valve replacement was performed in the patients. Careful and close follow-up is required for patients who had undergone CARVAR surgery, and aortic valve surgery should be performed in a timely manner if needed.

No MeSH data available.


All the reconstructed aortic valve leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened.
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f2-kjtcv-48-359: All the reconstructed aortic valve leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened.

Mentions: In the current evaluation, the follow-up echocardiography revealed severe AV stenosis with an AV area of 0.70 cm2 and motion limitation of the right coronary cusp. Details of the AV leaflet morphology and dynamics were confirmed by computed tomography images (Fig. 1). Intraoperatively, periaortic adhesion was very extensive, particularly around the outer ring, and then, transverse aortotomy was performed just above the ring. After removing the inner ring of the STJ and resecting the AV leaflets, aortic valve replacement (AVR) was performed using mechanical prosthesis (Overline, 18 mm; Sorin Biomedica, Saluggia, Italy). All the reconstructed AV leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened (Fig. 2), which led to motion impairment in the right coronary cusp as well as motion limitations in the left and non-coronary cusp. The redo-AVR was completed uneventfully with smooth weaning of cardiopulmonary bypass (CPB). The postoperative course was also uneventful.


Neo-Leaflet Failure after Comprehensive Aortic Root and Valve Reconstruction.

Park SJ, Lee JW, Chung CH - Korean J Thorac Cardiovasc Surg (2015)

All the reconstructed aortic valve leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4622036&req=5

f2-kjtcv-48-359: All the reconstructed aortic valve leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened.
Mentions: In the current evaluation, the follow-up echocardiography revealed severe AV stenosis with an AV area of 0.70 cm2 and motion limitation of the right coronary cusp. Details of the AV leaflet morphology and dynamics were confirmed by computed tomography images (Fig. 1). Intraoperatively, periaortic adhesion was very extensive, particularly around the outer ring, and then, transverse aortotomy was performed just above the ring. After removing the inner ring of the STJ and resecting the AV leaflets, aortic valve replacement (AVR) was performed using mechanical prosthesis (Overline, 18 mm; Sorin Biomedica, Saluggia, Italy). All the reconstructed AV leaflets consisting of a native leaflet and a bovine pericardial patch were thickly stiffened (Fig. 2), which led to motion impairment in the right coronary cusp as well as motion limitations in the left and non-coronary cusp. The redo-AVR was completed uneventfully with smooth weaning of cardiopulmonary bypass (CPB). The postoperative course was also uneventful.

Bottom Line: The comprehensive aortic root and valve reconstruction (CARVAR) technique comprises two main procedures, which are aortic root reduction using prosthetic rings and neo-leaflet reconstruction using a pericardial patch.After resecting the reconstructed leaflets, aortic valve replacement was performed in the patients.Careful and close follow-up is required for patients who had undergone CARVAR surgery, and aortic valve surgery should be performed in a timely manner if needed.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.

ABSTRACT
The comprehensive aortic root and valve reconstruction (CARVAR) technique comprises two main procedures, which are aortic root reduction using prosthetic rings and neo-leaflet reconstruction using a pericardial patch. Although concerns about durability of the pericardial neo-leaflet have been raised in the CARVAR technique, complications related to leaflet reconstruction have not been reported to date. The present report describes two cases of complications associated with leaflet reconstruction. After resecting the reconstructed leaflets, aortic valve replacement was performed in the patients. Careful and close follow-up is required for patients who had undergone CARVAR surgery, and aortic valve surgery should be performed in a timely manner if needed.

No MeSH data available.