Aortic Root Surgery: The Biological Solution

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Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer
Springer Science & Business Media, Mar 1, 2010 - Medical - 616 pages
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The surgical treatment of the aortic valve and root disease, organic and ischemic mitral regurgitation, and endocarditis has made great strides. Still, there is the well-known dilemma: on the one hand the need for anticoagulation in patients with mechanical valves that otherwise guarantee long-term functioning and, on the other, the unpredictable durability of biological substitutes and of valve repair procedures which, per se, do not require anticoagulation. The choice of procedure is determined by factors such as patients' age, metabolic and bleeding disorders, and bleeding preconditions, as well as such critical issues as the desire to bear children in young women.

The book contains a collection of proceedings of The Berlin Heart Valve Symposium which was held in November 2008. It focuses on current surgical approaches to and evolving trends in aortic valve repair, aortic root and valve replacement with pulmonary autograft, aortic allograft, stentless and stented bioprostheses. Further contributions will deal with recent advances in catheter-based percutaneous and transapical techniques, ablation techniques for atrial fibrillation, tissue engineering of heart valves, multi-modality imaging, and anticoagulation.

 

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Contents

Perioperative imaging for assessing aortic and mitral valve diseases and surgical procedures
4
Innovations in aortic valve surgery
12
The aortic root
13
The CoreValve prosthesis
22
Transapical aortic valve implantation a truly minimally invasive option for highrisk patients
32
From minimally invasive to percutaneous aortic valve replacement
46
Sutureless equine aortic valve replacement
57
Aortic valve and root replacement with pulmonary autograft
64
longterm clinical and hemodynamic results
346
19912008
356
Medtronic stentless Freestyle porcine aortic valve replacement
366
The ATS 3 f Aortic Bioprosthesis
386
The Vascutek Elan stentless porcine prosthesis the Glasgow experience
396
Sorin pericardial valves Operative technique and early results of biological valves
406
Stented bioprostheses
417
20 years durability of CarpentierEdwards Perimount stented pericardial aortic valve
441

a review of the literature
67
two decades of clinical experience
74
Aortic valve repair and valve sparing root procedures
86
The bicuspid aortic valve
89
the tale of the ring
102
success and failures
133
Aortic annuloplasty
144
Correction of aortic valve incompetence combined with ascending aortic aneurysm by relocation of the aortic valve plane through a shortlength aorti...
178
Using BioGlue to achieve hemostasis in aortic root surgery
185
Endocarditis
192
Challenges in the surgical management of infective endocarditis
195
Double valve endocarditis and evolving paraannular abscess formation
223
reconstruction of the left ventricular outflow tract and allograft aortic valve and root replacement
243
Implantation techniques of freehand subcoronary aortic valve and root replacement with a cryopreserved allograft for aortic root abscess
274
Surgeryfor atrial fibrillation
288
Cryoablation for the treatment of atrial fibrillation in patients undergoing minimally invasive mitral valve surgery
291
Minimally invasive endoscopic ablation on the beating heart in patients with lone atrial fibrillation
302
Hemodynamice valuation of the bioprosthetic aortic valves
311
Evaluation of bioprosthetic valve performance as a function of geometric orifice area and space efficiency
312
Longterm results of biological valves
338
Stentless bioprostheses
339
Twentyyear experience with the St Jude Medical Biocor bioprosthesis in the aortic position
452
20Year durability of bioprostheses in the aortic position
463
Clinical results including hemodynamic performance of the Medtronic Mosaic porcine bioprosthesis up to ten years
470
Aortic root replacement with the BioValsalva prosthesis
487
bioprostheses versus mechanical prostheses
498
Replacement of bioprostheses after structural valve deterioration
503
Predictors of patients outcome
520
Predicted outcomes after aortic valve replacement in octogenarians with aortic stenosis
521
Predicted patient outcome after bioprosthetic AVR and the Ross operation
530
Anticoagulation
539
midterm results
541
Tissue engineering
549
Biomatrixpolymer hybrid material for heart valve tissue engineering
550
Standards for the in vitro fabrication of heart valves using human umbilical cord cells
564
Tissue engineering with a decellularized valve matrix
574
Regularatory issues on tissue valves
579
regulatory requirements
581
Concluding remarks
588
Atlas of biological valves
591
Subject index
599
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