1
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Danial P, Moiroux-Sahraoui A, Nelly A, Pontailler M, Gaudin R, Lansac E, Pavy C, Bonnet D, Vouhé P, Raisky O. Outcomes of aortic valve repair in children stratified by complexity: Which outcome for which lesion? J Thorac Cardiovasc Surg 2024; 167:1533-1542.e6. [PMID: 38008207 DOI: 10.1016/j.jtcvs.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE Aortic valvuloplasty frequency has significantly increased over the past 15 years. Surgical repair varies in complexity depending on valvular lesions. Our aim is to report results on the whole spectrum of aortic valvuloplasty techniques. METHODS All children who consecutively underwent aortic valvuloplasty for aortic stenosis and/or aortic insufficiency between January 2006 and December 2020 at Necker Sick Children's Hospital (Paris, France) were included in a retrospective cohort study. Aortic valvuloplasty techniques were classified into 3 difficulty levels: (1) simple repair, corresponding to commissurotomy and/or shaving in aortic stenosis (AS) in neonates (group 1) and children >1 month (group 2); (2) intermediate-complexity repair, corresponding to commissuroplasty, leaflet resuspension, and fenestration closure in aortic insufficiency (leaflet prolapse in connective tissue disease, isolated leaflet prolapse and Laubry-Pezzi groups); and (3) complex repair requiring a pericardial patch to restore a functional aortic valve in mixed aortic valve disease (bicuspidization with neocommissure and cusp extension groups). RESULTS During the study period, 324 children underwent aortic valvuloplasty. Survival and freedom from aortic valve reintervention at 10 years were, respectively, 86.1% and 50.9% in neonates with AS, 95.2% and 71.7% in children >1 month with AS, 93.8% and 79.5% in leaflet prolapse in connective tissue disease, 97.7% and 91.9% in isolated leaflet prolapse, 100% and 88% in those with Laubry-Pezzi syndrome, 97.4% and 84.8% in bicuspidization with neocommissure, and 100% and 54.2% in the cusp extension. CONCLUSIONS Durability of aortic valvuloplasty techniques is satisfactory and offers the possibility to delay the Ross procedure, regardless of the lesion's complexity.
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Affiliation(s)
- Pichoy Danial
- Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; INI-CRCT, F-CRIN, Nancy, France
| | - Alexander Moiroux-Sahraoui
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Asma Nelly
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Margaux Pontailler
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Régis Gaudin
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Emmanuel Lansac
- Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Carine Pavy
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Damien Bonnet
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Pascal Vouhé
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Olivier Raisky
- Department of Pediatric Cardiac Surgery, Necker Sick Children Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France.
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Jasinski MJ, Jasinski J, Kansy A. Leaflet to annulus ratio of 1.5 proves superior and easy to adopt. J Thorac Cardiovasc Surg 2024:S0022-5223(24)00159-4. [PMID: 38430104 DOI: 10.1016/j.jtcvs.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Jasinski
- Department of Cardiac Surgery, Silesia Medical University, Katowice, Poland
| | - Andrzej Kansy
- Pediatric Cardiac Surgery, Childrens Memorial Health Institute, Warsaw, Poland
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3
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Jasinski MJ, Kosiorowska K, Berezowski M. Bicuspid aortic valve repair: Functional aortic annulus remodeling is a goal. J Thorac Cardiovasc Surg 2024; 167:e37-e38. [PMID: 37061908 DOI: 10.1016/j.jtcvs.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/12/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikolaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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4
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Jasinski MJ, Kosiorowska K, Joshua M, Berezowski M. Annuloplasty during aortic valve sparing: "Two heads (rings) are better than one". J Thorac Cardiovasc Surg 2023; 166:e390-e391. [PMID: 37149813 DOI: 10.1016/j.jtcvs.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Manalo Joshua
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikolaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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5
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Gerdisch MW, Burkhart HM, Fiore AC, Rankin JS. Ross redux versus aortic valve repair. Eur J Cardiothorac Surg 2023; 64:ezad306. [PMID: 37682114 DOI: 10.1093/ejcts/ezad306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023] Open
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6
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Benhassen LL, Hedensted JH, Hasenkam JM, Johansen P. Reply to Jasinski et al. Eur J Cardiothorac Surg 2023; 64:ezad312. [PMID: 37738585 DOI: 10.1093/ejcts/ezad312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Indexed: 09/24/2023] Open
Affiliation(s)
- Leila Louise Benhassen
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Hesselby Hedensted
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - John Michael Hasenkam
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Johansen
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Electrical and Computer Engineering, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
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7
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Jasinski MJ, Nowicki R, Jasinski J, Bielicki G, Rachwalik M, Berezowski M. Functional aortic annulus remodelling-revisited. Eur J Cardiothorac Surg 2023; 64:ezad320. [PMID: 37740291 DOI: 10.1093/ejcts/ezad320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/21/2023] [Indexed: 09/24/2023] Open
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
- Department Congenital Cardiac Surgery Children, Memorial Pediatric Health Institute, Warsaw, Poland
| | - Rafal Nowicki
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Jasinski
- Department of Cardiac Surgery, Silesian Medical University, Katowice, Poland
| | - Grzegorz Bielicki
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Rachwalik
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikolaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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8
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Jasinski MJ, Kosiorowska K, Berezowski M. Gradients after bicuspid aortic valve repair: Good, bad, or ugly? J Thorac Cardiovasc Surg 2023; 166:e71-e72. [PMID: 36906397 DOI: 10.1016/j.jtcvs.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/13/2023]
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikolaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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9
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Shraer N, Youssefi P, Lansac E. Reply: What is a good annuloplasty for bicuspid aortic valve repair? JTCVS OPEN 2023; 14:87-88. [PMID: 37425475 PMCID: PMC10328793 DOI: 10.1016/j.xjon.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Nathanael Shraer
- Department of Pediatric Cardiac Surgery, Necker APHP Hospital, Paris, France
| | - Pouya Youssefi
- Department of Cardiac Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom
| | - Emmanuel Lansac
- Department of Cardiovascular and Thoracic Surgery, Pitié-Salpêtrière APHP Hospital, Paris, France
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10
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Rankin JS, Deja MA. Commentary: Achieving "symmetrical" annular geometry during bicuspid aortic valve repair. J Thorac Cardiovasc Surg 2022:S0022-5223(22)01349-6. [PMID: 36610885 DOI: 10.1016/j.jtcvs.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- J Scott Rankin
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
| | - Marek A Deja
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
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11
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Deja MA, Gocol R, Rankin JS, Wei LM, Badhwar V, Jasinski MJ. Autologous repair of "very asymmetric" bicuspid aortic valves using geometric ring annuloplasty. JTCVS Tech 2022; 16:17-20. [PMID: 36510534 PMCID: PMC9737026 DOI: 10.1016/j.xjtc.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Marek A. Deja
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland,Deapartment of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland,Address for reprints: Marek A. Deja, MD, PhD, Department of Cardiac Surgery, Medical University of Silesia, ul Ziołowa 45-47, 40-635 Katowice, Poland.
| | - Radoslaw Gocol
- Deapartment of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
| | - J. Scott Rankin
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
| | - Lawrence M. Wei
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
| | - Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
| | - Marek J. Jasinski
- Deaprtement of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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12
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Jasinski MJ, Kosiorowska K, Berezowski M, Kansy A. Unicuspid aortic valve repair-Same principles, different methods. J Card Surg 2022; 37:3467-3468. [PMID: 36040656 DOI: 10.1111/jocs.16894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Marek J Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikołaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Kansy
- Department of Pediatric Cardiothoracic Surgery, Children's Memorial Pediatric Health Institute, Warsaw, Poland
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13
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Gerdisch MW, Austin EH, Vester SR, Stavridis GT, Singhal A, Weber A, Deja MA, Wei LM, Badhwar V, Rankin JS. Evolution of techniques for repair of intermediate-type bicuspid aortic valves. JTCVS Tech 2022; 15:62-69. [PMID: 36276700 PMCID: PMC9579988 DOI: 10.1016/j.xjtc.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/11/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022] Open
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14
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BAV repair algorithm: 20 years experience. CIRUGIA CARDIOVASCULAR 2022. [DOI: 10.1016/j.circv.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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15
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Gerdisch MW, Reece TB, Emerson D, Downey RS, Blossom GB, Singhal A, Baker JN, Fischlein TJ, Badhwar V. Early results of geometric ring annuloplasty for bicuspid aortic valve repair during aortic aneurysm surgery. JTCVS Tech 2022; 14:55-65. [PMID: 35967205 PMCID: PMC9367630 DOI: 10.1016/j.xjtc.2022.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives Geometric ring annuloplasty has shown promise during bicuspid aortic valve repair for aortic insufficiency. This study examined early outcomes of bicuspid aortic valve repair associated with proximal aortic aneurysm replacement. Methods From September 2017 to November, 2021, 127 patients underwent bicuspid aortic valve repair with concomitant proximal aneurysm reconstruction. Patient age was 50.6 ± 12.7 years (mean ± standard deviation), male gender was 83%, New York Heart Association Class was 2 (1-2) (median [interquartile range]), and preoperative aortic insufficiency grade was 3 (2-4). Ascending aortic diameter was 50 (46-54) mm, and all patients had ascending aortic replacement. Forty patients had sinus diameters greater than 45 mm, prompting remodeling root procedures. A total of 105 patients had Sievers type 1 valves, 3 patients had type 0, and 7 patients had type 2. A total of 118 patients had primarily right/left fusion, 8 patients had right/nonfusion, and 1 patient had left/nonfusion. Leaflet reconstruction used central leaflet plication and cleft closure, with limited ultrasonic decalcification in 31 patients. Results Ring size was 23 (21-23) mm, and 26 of 40 root procedures were selective nonfused sinus replacements. Aortic clamp time was 139 (112-170) minutes, and bypass time was 178 (138-217) minutes. Postrepair aortic insufficiency grade was 0 (0-0) (P < .0001), and mean valve gradient was 10 (7-14) mm Hg. No early and 1 late mortality occurred. Four patients required reoperation for bleeding, and 4 patients required pacemakers. At a mean follow-up of 20 months (maximal 93), there were no valve-related complications, 5 late repair failures prompting valve replacement, and 1 death due to Coronavirus Disease 2019. Conclusions Geometric ring annuloplasty for bicuspid aortic valve repair with proximal aortic aneurysm reconstruction is safe and associated with good early outcomes. Further experience and follow-up will help inform long-term durability.
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Affiliation(s)
- Marc W. Gerdisch
- Department of Cardiac Surgery, Franciscan Health Indianapolis, Indianapolis, Ind
- Address for reprints: Marc W. Gerdisch, MD, Department of Cardiac Surgery, Franciscan Health Indianapolis, Indianapolis, IN 46237.
| | - T. Brett Reece
- Department of Cardiac Surgery, University of Colorado, Aurora, Colo
| | - Dominic Emerson
- Department of Cardiac Surgery, Cedars Sinai Medical Center, Los Angeles, Calif
| | - Richard S. Downey
- Department of Cardiac Surgery, University of Michigan, Muskegon, Mich
| | - Geoffrey B. Blossom
- Department of Cardiac Surgery, Ohio Health Riverside Methodist Hospital, Columbus, Ohio
| | - Arun Singhal
- Department of Cardiac Surgery, University of Iowa, Iowa City, Iowa
| | - Joshua N. Baker
- Department of Cardiac Surgery, Missouri Baptist Hospital, St Louis, Mo
| | - Theodor J.M. Fischlein
- Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - Vinay Badhwar
- Department of Cardiac Surgery, West Virginia University, Morgantown, WVa
| | - BAVr Working GroupTrentoAlfredoaChikweJoannaaWeiLawrence M.bGlotzbachJason P.cJamesTimothy W.dQuinnReed D.eWolfeJ. AlanfYamaneKentarogCopeJeffrey T.gSolemaniBehzadgTakayamaHiroohRodriguezVictor M.iMurashitaTakashijVoellerRochus K.kSiMing-SinglLevackMelissamBurkeChris R.nMoonMarc R.oKraevAlexanderpJasinskiMarek J.qStavridisGeorgiosrRankinJ. ScottbCedars Sinai Medical Center, Los Angeles, CalifWest Virginia University, Morgantown, WVaUniversity of Utah, Salt Lake City, UtahSt Joseph's Medical Center, Tacoma, WashMaine Medical Center, Portland, MaineNortheast Georgia Medical Center, Gainesville, GaPennsylvania State University, Hershey, PaColumbia Presbyterian Medical Center, New York, NYUniversity of California Davis, Sacramento, CalifUniversity of Missouri, Columbia, MoUniversity of Minnesota, Minneapolis, MinnUniversity of Michigan, Ann Arbor, MichVanderbilt University Medical Center, Nashville, TennUniversity of Washington, Seattle, WashWashington University Medical Center, St Louis, MoBillings Clinic, Billings, MontWroclaw Medical University, Wroclaw, PolandOnassis Heart Center, Athens, Greece
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Jasinski M, Kosiorowska K. Long‐term durability of valve‐sparing or repair procedures in BAV—Is there room for improvement? J Card Surg 2022; 37:1456. [DOI: 10.1111/jocs.16341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Marek Jasinski
- Clinical Department of Cardiac Surgery Wroclaw Medical University Wroclaw Poland
| | - Kinga Kosiorowska
- Clinical Department of Cardiac Surgery Wroclaw Medical University Wroclaw Poland
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17
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Jasinski M, Kosiorowska K, Berezowski M. Assessment of aortic annuloplasty techniques-is the jury already in? Eur J Cardiothorac Surg 2021; 62:6486866. [PMID: 34964461 DOI: 10.1093/ejcts/ezab569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/21/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Marek Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Mikołaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
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18
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Acharya M, Sherzad H, Tan SZCP, Bashir M, Mariscalco G. External or subcomissural annuloplasty in bicuspid aortic valve repair: Which is better? J Card Surg 2021; 37:532-534. [PMID: 34820900 DOI: 10.1111/jocs.16152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/27/2022]
Abstract
Patients with a bicuspid aortic valve (BAV) are at increased risk of valvular regurgitation compared to their counterparts with a tri-leaflet aortic valve. There is now increasing emphasis to offer BAV repair to mitigate the risks of prosthesis-related complications, including thromboembolism, hemorrhage and endocarditis, as well as structural valve deterioration and future reoperation with conventional valve replacement, particularly in younger populations. Furthermore, over the preceding two decades, our greater understanding of the functional anatomy of the BAV, pathophysiological mechanisms of BAV insufficiency, and the development of a functional classification of aortic regurgitation have significantly contributed to the evolution of aortic valve reconstructive surgery. In this commentary, we discuss a recent article from the Journal of Cardiac Surgery comparing external annuloplasty and subcommissural annuloplasty as techniques for BAV repair.
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Affiliation(s)
- Metesh Acharya
- Department of Cardiac Surgery, Glenfield Hospital, Leicester, UK
| | - Hiwa Sherzad
- Department of Cardiac Surgery, Glenfield Hospital, Leicester, UK
| | | | - Mohamad Bashir
- Division of Vascular and Endovascular Surgery, Health Education and Improvement Wales, Nantgarw, UK
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19
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Jasinski M, Kosiorowska K. Solid aortic annuloplasty opening up for new valve sparing options. J Card Surg 2021; 36:4196-4197. [PMID: 34453330 DOI: 10.1111/jocs.15946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Marek Jasinski
- Clinical Department of Cardiac Surgery, Wroclaw Medical University, Wrocław, Poland.,Department of Cardiac Surgery, Children's Memorial Pediatric Health Institute, Warsaw, Poland
| | - Kinga Kosiorowska
- Clinical Department of Cardiac Surgery, Wroclaw Medical University, Wrocław, Poland
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20
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Jasinski M, Kosiorowska K, Berezowski M. Gradients after AV repair - to worry or not to worry? Ann Thorac Surg 2021; 114:610-611. [PMID: 34297987 DOI: 10.1016/j.athoracsur.2021.06.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Marek Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Borowska 213 50-556 Wroclaw, Poland
| | - Kinga Kosiorowska
- Department of Cardiac Surgery, Wroclaw Medical University, Borowska 213 50-556 Wroclaw, Poland.
| | - Mikołaj Berezowski
- Department of Cardiac Surgery, Wroclaw Medical University, Borowska 213 50-556 Wroclaw, Poland
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21
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Youssefi P, Pepper J. A new age of aortic valve repair. Eur J Cardiothorac Surg 2021; 60:1062-1063. [PMID: 34008012 DOI: 10.1093/ejcts/ezab258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pouya Youssefi
- Department of Cardiac Surgery, Royal Brompton & Harefield Hospital, London, UK
| | - John Pepper
- National Heart & Lung Institute, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, London, UK
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