Simultaneous Repair of Severe Pectus Excavatum and Aortic Valve Replacement Following Previous Open-Heart Surgery

1988 ◽  
Vol 45 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Warren L. Gould ◽  
G.K. Jett ◽  
John Bostwick ◽  
Ellis L. Jones ◽  
Kamal A. Mansour
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pectus Excavatum ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart

Abstract 16920: Transcatheter Aortic Valve Replacement in Aortic Regurgitation: The U.S. Experience

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chinmy T Jani ◽  
Shilpkumar Arora ◽  
Sopan Lahewala ◽  
ZACHARY ZUZEK ◽  
Rahul Jaswaney ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Vascular Complications ◽  
Paravalvular Leak ◽  
Open Heart ◽  
Transcatheter Aortic Valve

Background: Transcatheter aortic valve replacement (TAVR) may be an effective option for high-risk AR patients. Although international experiences of TAVR for AR are published, U.S. data is limited. The primary objective of this study was to investigate periprocedural and 30-days outcomes in terms of mortality and post-procedural complications in patients undergoing TAVR for AR using large national U.S. databases. Hypothesis: TAVR is a promising option in AR Methods: Study cohorts were derived from Nationwide Inpatient Sample (NIS) and Nationwide Readmissions Database (NRD) 2016-17. TAVR and AR were identified using ICD-10-CM-codes. The key outcomes were all-cause mortality, disabling stroke, valvular complications, complete heart block (CHB)/ permanent pacemaker placement (PPM), open heart surgery, acute kidney injury (AKI) requiring dialysis, and vascular complications. Multivariate logistic regression was used to adjust for confounders. Results: 915 patients from the NIS (male-71%, age 65-84.2%) and 822 patients from the NRD (male-69.3%, age 65-80.5%) underwent TAVR for AR. The median length of stay (LOS) was 4 days for both cohorts. In-hospital mortality was 2.7% in NIS and 30-day mortality was 3.3% in NRD. Disabling strokes were noted in 0.6% peri-procedurally and 1.8% at 30-days. Valve-related complications were 18-19% with paravalvular leak being the most common. Approximately 11% of patients developed CHB and/or needed PPM in both cohorts. In NRD, 2.2% of patients required dialysis for AKI, 1.5% developed vascular complications, and 0.6% required open-heart surgery within 30-days post-procedure. Anemia was predictive of increased overall complications and valvular complications, whereas, peripheral vascular disease was predictor of increased valvular complications and CHB/PPM. Conclusion: TAVR is a promising option in AR. Further studies are necessary for the expansion of TAVR as standard treatment in AR.

A Clinical Study of Isolated Aortic Valve Replacement: A Univariate Analysis of Risk Factors

1993 ◽  
Vol 1 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Kim Wook Sung ◽  
Lee Jeong Ryul ◽  
Kim Ki Bong ◽  
Sung Sook Whan ◽  
Ahn Hyuk ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Nyha Class ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Open Heart Surgery ◽  
Class Iii ◽  
Preoperative Serum

Between 1979 and 1990, 190 patients underwent isolated aortic valve replacement at Seoul National University Hospital in Korea. There were 11 (5.8%) in-hospital deaths. Univariate analysis identified advanced age (p = 0.026), preoperative serum GOT or GPT greater than 40IU/1 (p < 0.001, p = 0.003), NYHA Class III or IV (p = 0.029), preoperative mean pulmonary arterial pressure greater than 19 mmHg (p = 0.019), reoperation for aortic valve replacement (p = 0.035), second or third open heart surgery (p < 0.001), and use of mechanical valve (p = 0.008) as variables associated with increased in-hospital risk. Follow-up documented survival rates of 98.1% and 96.4% and event-free survival rates of 95.7% and 81.6% at 3 and 7 postoperative years, respectively. NYHA Class III or IV (p = 0.009), preoperative serum total bilirubin level greater than 1.2 mg/dl (p = 0.009), reoperation for aortic valve replacement (p = 0.03), second or third open heart surgery (p = 0.002), and use of mechanical valve were associated with decreased late survival and event-free survival.

Patient-Specific Computational Simulations of Transcatheter Aortic Valve Implantation (TAVI)

2013 ◽  
Author(s):  
Giorgia M. Bosi ◽  
Claudio Capelli ◽  
Robin Chung ◽  
Michael Mullen ◽  
Andrew M. Taylor ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Vascular Complications ◽  
Negative Influence ◽  
Paravalvular Leak ◽  
Patient Specific ◽  
Transcatheter Aortic Valve

In the past decade, Transcatheter Aortic Valve Replacement (TAVI) has been shown to be a feasible, less invasive option to open heart surgery for aortic valve replacement; however, TAVI is indicated only in patients with severe, symptomatic, aortic stenosis and who are considered at high or prohibitive risk for conventional surgery [1]. To date, two different TAVI devices are available on the market — the balloon-expandable Edwards-Sapien® Valve (Edwards Lifesciences, CA, USA) and the self-expandable CoreValve ReValving System® (Medtronic, MN, USA) — with many other devices currently under development and clinical trials. The procedural success rate has been >90% in all studies [1], but vascular complications, electrical conduction abnormalities and paravalvular leak — 65–89% of cases, the majority being trivial to mild, with 0 to 26% moderate and 0 to 10% severe — still remain major safety concerns. In particular, a negative influence of moderate to severe paravalvular leak on survival rates has recently been demonstrated [2].

scholarly journals Aortic Annular Enlargement during Aortic Valve Replacement

2016 ◽  
Vol 4 (3) ◽  
pp. 455-457 ◽  
Author(s):  
Selman Dumani ◽  
Ermal Likaj ◽  
Laureta Dibra ◽  
Stavri Llazo ◽  
Ali Refatllari
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Aortic Annulus ◽  
Patient Prosthesis Mismatch ◽  
Potential Benefits ◽  
Transvalvular Gradient

In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

scholarly journals Prosthetic Valve Endocarditis with Valvular Obstruction after Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 42 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Christine Pabilona ◽  
Bernard Gitler ◽  
Jeffrey A. Lederman ◽  
Donald Miller ◽  
Theodore N. Keltz
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Prosthetic Valve Endocarditis ◽  
Transcatheter Aortic Valve

Patients with severe aortic stenosis who are at high risk for open-heart surgery might be candidates for transcatheter aortic valve replacement (TAVR). To our knowledge, this is the first report of Streptococcus viridans endocarditis that caused prosthetic valve obstruction after TAVR. A 77-year-old man who had undergone TAVR 17 months earlier was admitted because of evidence of prosthetic valve endocarditis. A transthoracic echocardiogram revealed a substantial increase in the transvalvular peak gradient and mean gradient in comparison with an echocardiogram of 7 months earlier. A transesophageal echocardiogram showed a 1.5-cm vegetation obstructing the valve. Blood cultures yielded penicillin-sensitive S. viridans. The patient was hemodynamically stable and was initially treated with vancomycin because of his previous penicillin allergy. Subsequent therapy with levofloxacin, oral penicillin (after a negative penicillin skin test), and intravenous penicillin eliminated the symptoms of the infection. Transcatheter aortic valve replacement is a relatively new procedure, and sequelae are still being discovered. We recommend that physicians consider obstructive endocarditis as one of these.

scholarly journals Surgical treatment for accidentally discovered pseudoaneurysm of the mitral-aortic intervalvular fibrosa with bicuspid aortic valve, ascending aortic aneurysm, and myocardial ischemia: a case report

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Kentaro Kiryu ◽  
Gembu Yamaura ◽  
Itaru Igarashi ◽  
Takayuki Kadohama ◽  
Fuminobu Tanaka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Ascending Aortic Aneurysm

Abstract Background Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare complication of infective endocarditis and aortic valve replacement. Ruptured P-MAIVF and angina due to compression of the coronary arteries are severe complications of this condition. Case presentation We report a case of P-MAIVF that was diagnosed accidentally during a routine checkup. The patient was asymptomatic; however, she had a systolic murmur. She had a history of infective endocarditis, which was treated conservatively without open-heart surgery. In addition, she was diagnosed with aortic valve stenosis, aortic valve regurgitation, bicuspid aortic valve, right coronary artery stenosis, and an ascending aortic aneurysm. She was treated with surgery, which involved patch closure of P-MAIVF with aortic valve replacement, coronary artery bypass grafting, and ascending aorta replacement. After the operation, echocardiography showed no leakage from the P-MAIVF. Conclusions It is necessary to have knowledge of P-MAIVF. Following up cases of infective endocarditis and post-aortic valve replacement using echocardiography is important for both, diagnosing P-MAIVF and preventing serious complications such rupture and angina.

scholarly journals Emergency aortic valve replacement complicated by unsuspected pheochromocytoma

2021 ◽  
Author(s):  
Rihito Tamaki ◽  
Manabu Yamasaki ◽  
Hiroyuki Nishi ◽  
Kunihiko Yoshino ◽  
Kohei Abe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Early Recognition ◽  
Hypertensive Crisis ◽  
Open Heart Surgery ◽  
Pressure Change ◽  
Pressure Control

A 53-year-old male undergoing emergency aortic valve replacement for infective endocarditis developed a hypertensive crisis early during the operation. Suspecting a pheochromocytoma, intravenous phentolamine was immediately administered, after which the procedure was completed as scheduled. Although quite rare, a pheochromocytoma can be encountered during emergency open heart surgery, thus early recognition of abnormal blood pressure change and appropriate management are important. Here, we present details of blood pressure control mainly by phentolamine use in this case to demonstrate effective management of a hypertensive crisis during emergency cardiac surgery because of a pheochromocytoma.

FLOW PATTERNS AND HEMODYNAMIC EFFICACY ANALYSIS IN A NOVEL PERCUTANEOUS STENTED AORTIC VALVE

2011 ◽  
Vol 23 (01) ◽  
pp. 63-74
Author(s):  
Gideon Praveen Kumar ◽  
Lazar Mathew
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Valves ◽  
Efficacy Analysis ◽  
First Choice ◽  
Percutaneous Valve Replacement ◽  
Percutaneous Valve

Recently, percutaneous valve replacement has emerged as an alternative treatment for stenosis of mitral, aortic, and pulmonary valves, replacing the surgical approach and providing a new perspective on transcatheter placement of cardiac valves. The conventional open heart surgery does not suit most of the cardiothoracic patient population for various reasons. Percutaneous valve replacement has started becoming the first choice for surgical replacement of the cardiac valves. Under such a scenario where good potent porcine valves made from the pericardium of pigs are being made available, the real question is designing and developing cost effective stents to bear these valves. The ones that are imported are highly expensive which cannot be afforded by some of the Indian population. This also has substantial benefits from the standpoints of health, safety, and cost. The manufacturing of a stented aortic valve is an absolutely critical job, which requires proper designs, finite element analysis, and flow dynamics studies. This paper forms the base for an eventual manufacture of stented aortic valves, giving in-depth details pertaining to design and implantation of the bioprosthesis in the aorta with flow pattern analysis postimplantation and its hemodynamic efficacy analysis. Blood flow analysis and associated hemodynamic analysis help to understand the leakage resistance of the stented valve. A valve of this kind will enable minimal invasive cardiac surgeons to perform percutaneous aortic valve replacement with ease. This would also be an economic procedure allaying the high costs that are typically involved in conventional open heart surgery. We believe that this model has great potential for helping to set up a protocol for the growing of a tissue engineered heart valve construct.

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