BACKGROUND: Aortic valve bypass (AVB [apicoaortic conduit]) relieves aortic stenosis (AS) by connecting the apex of the left ventricle to the descending thoracic aorta with a valved conduit. AVB is performed through a small left thoracotomy, without cardiopulmonary bypass, aortic cross-clamping, cardiac arrest, or debridement of the native aortic valve. ...

Unicuspid aortic valve is a rare pathology among congenital heart diseases that requires cardiac surgery and is often confused with bicuspid valve. Herein, we report a case of a unicommisural form of unicuspid aortic valve concomitant with aortic aneurysm and secundum type atrial septal defect.

This case report describes a percutaneous aortic valve implantation with the Medtronic CoreValve selfexpanding valve prosthesis in a patient with severe aortic stenosis. The approach was made via the left subclavian artery because of the lack of femoral vessel access. The patient was a 78-year-old female with breathlessness on minimal ...

The aim of the study was to validate a novel formula for aortic valve area (AVA) based on the principle of continuity equation, that substitutes Doppler-derived stroke volume (SV) by SV directly measured with real time simultaneous triplane three-dimensional echocardiography (RT3P). RT3P has proved accuracy for left ventricular volume calculation. ...

The biomechanics of the aortic valve are altered in patients with ventricular assist devices (VADs). During high VAD flow and low cardiac function, transvalvular pressure is high, and the aortic valve remains closed throughout the cardiac cycle. This condition has been linked to the development of aortic valve fusion and ...

Aortoventricular disruption after aortic valve replacement is extremely rare. A case of aortoventricular disruption following aortic valve replacement is described in detail, and related case reports are reviewed. A 76-year-old male underwent aortic valve replacement with a tissue valve using everting mattress sutures, repair of the ascending aortic aneurysm, and ...

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired bone marrow disorder characterized by hemolytic anemia, neutropenia, thrombocytopenia, hemoglobinuria, and venous thrombosis. Cardiopulmonary bypass-induced complement activation may be associated with exacerbation of hemolysis in patients with PNH undergoing cardiac operations. We describe a 77-year-old man with PNH and critical symptomatic aortic ...

Bicuspid aortic valve (BAV), the most common form of congenital heart disease, is a leading cause of aortic stenosis (AS) and aortic insufficiency (AI). AS is typically caused by calcific valve disease. Recently, microRNAs (miRNAs) have been shown to modulate gene expression. The study aim was to examine the miRNAs ...

Quadricuspid aortic valve (QAV) is a rare congenital lesion, generally manifesting with valve regurgitation. Standard treatment involves valve replacement, though anecdotal cases of successful repair by means of valve tricuspidization have been reported. Here, the successful application of a repair technique previously unreported in the setting of QAV is described.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether statins slow the process of calcification of aortic tissue valves. Altogether 207 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. ...

Percutaneous transfemoral aortic valve replacement is a new rapidly evolving technique that has made significant progress in recent years. The technology is however limitted and in some cases has resulted in failure to deliver the prosthetic valve.We describe a new technique using a buddy balloon, from the contralateral femoral artery, ...

Hyaluronan (HA) is a major component of the interstitium and has been observed in normal heart valves. The function of HA in heart valves is unknown but contribution to biomechanical function has been proposed. The purpose of this investigation was to study the distribution of HA in relation to calcifications ...

Pentacuspid aortic valve is an extremely rare congenital aortic valve anomaly. In this case, pentacuspid aortic valve with severe aortic regurgitation was detected by transthoracic echocardiography and multiple-detector computed tomography; the patient recovered smoothly after aortic valve replacement.

A 69-year-old man with a medical history of neurofibromatosis was transferred to our hospital for the treatment of an aortic valve mass. His workup identified an aortic valve papillary fibroelastoma based on the absence of signs of infection, thrombus in the left atrium, and valvular destruction or abnormal valvular function. ...

Calcific aortic stenosis is the most frequent heart valve disease and the main indication for valve replacement in western countries. For centuries attributed to a passive wear and tear process, it is now recognized that aortic stenosis is an active inflammatory and potentially modifiable pathology, with similarities to atherosclerosis. Statins ...

As multiple new procedures now require better visualization of the aortic valve, we sought to better define the central aortic valve coaptation area seen during diastole on multi-detector row cardiac computed tomography (MDCT). 64-MDCT images of 384 symptomatic consecutive patients referred for coronary artery disease evaluation were included in the ...

Since 1989, data have been reported to the Society of Thoracic Surgeons National Adult Cardiac Surgery Database for quality improvement. This information is also data mined for national quality indicators, policy initiatives, and research. Such use has important limitations, because data elements cannot be verified for accuracy. We determined variability ...

OBJECTIVE: Patients with bicuspid aortic valves can present with aortic insufficiency caused by cusp disease or the aortic root pathology. We present our 13-year experience with a functional and systematic approach to bicuspid aortic valve repair. METHODS: Between 1995 and 2008, 122 consecutive patients (mean age, 44 +/- 11 years) ...

OBJECTIVE: We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). DESIGN: Prospective follow-up of asymptomatic patients with moderate to severe AS. The patients underwent clinical and Doppler echocardiographic evaluation. SETTING: Department of Cardiology. PATIENTS: 163 patients with moderate to severe ...

BACKGROUND AND AIM OF THE STUDY: Bicuspid aortic valve is the most common congenital heart malformation, and a high percentage of patients with this condition will develop complications over time. It is rare that pilots undergo aortic valve surgery, and the confirmation of flight-licensing requirements after aortic valve replacement (AVR) ...

A 41-year-old man who had been previously diagnosed with bicuspid aortic valve presented to our hospital with repeating episodes of fever. Echocardiography revealed vegetation in the bicuspid valve as well as left-to-right shunt, making one suspicious of rupture of the sinus of Valsalva. Under the diagnosis of infective endocarditis of ...

Aortic valve disease is a growing cause of mortality and morbidity, especially in developed countries. Whereas medical therapy is associated with an ominous prognosis, since the 1970s, surgical valve replacement has represented a standard therapy for fit patients. Indeed, this approach is safe and feasible in younger patients without comorbidities. ...

BACKGROUND AND AIM OF THE STUDY: Composite replacement is the standard treatment for the repair of aortic aneurysm with aortic valve pathology. With improved long-term durability and no requirement for long-term anticoagulation, tissue-valved conduits have become increasingly popular. Herein are reported the results achieved with 50 consecutive 'Bentall' operations, using ...

PURPOSE: Combined coronary artery bypass (CAB) and valve surgery is one of the most challenging surgical procedures, but the operative results have improved over the years. MATERIALS AND METHODS: From 1989 through 2004, combined CAB and valve operations were performed in 125 patients. Mean age was 63 years, and 86 ...

INTRODUCTION AND OBJECTIVES: The aim was to evaluate the usefulness of transesophageal echocardiography (TEE) for the preoperative functional anatomical assessment of patients with aortic regurgitation (AR) to identify those eligible for valve-sparing surgery (VSS). METHODS: We determined the accuracy and diagnostic value of TEE for identifying underlying lesions and mechanisms ...

We report a new technique of the partially and sequentially gonflage of the transcatheter balloon valve, the so called dog bone shaped technique, which allowed us to approach the aortic root by inflating the valve balloon in two different times, stabilizing the heart and deplacing the valve.

Quadricuspid aortic valve is a rare congenital malformation of the heart leading to significant aortic regurgitation or stenosis. Its diagnosis by transthoracic echocardiography is difficult. Most of the cases are diagnosed during surgery or autopsy. Associated abnormalities of the coronary arteries should also be searched, since surgical injury may have ...

Bicuspid aortic valve (BAV)-associated aortopathy is a complex phenomenon, and the current lack of univocal interpretation of its causes and treatment can be ascribed to the multiform nature of its clinical presentation. Although there is strong bias in the literature favoring more aggressive treatment of ascending aortic dilatation in patients ...

Transcatheter aortic valve implantation has been shown to be a feasible alternative to surgical aortic valve replacement in selected high-risk patients. Although, being less invasive, catheter techniques remain associated with the potential of serious complications. Procedural success and avoidance of such complications critically depends on careful patient selection and comprehensive ...

Surgical aortic valve replacement remains the gold standard for the treatment of severe, symptomatic aortic stenosis. However, percutaneous treatments are challenging this paradigm in high-risk surgical patients. Technological developments have been rapid in the field of percutaneous aortic valve intervention. Two devices have been approved for general use in Europe: ...

BACKGROUND: Reports on outcomes of acute type A aortic dissection (ATAAD) repair after previous cardiac surgery (PCS) are few. Some suggest no difference in mortality while others note decreased risk of free rupture due to adhesions. We analyzed our experience of ATAAD after PCS. METHODS: Between January 1992 and March ...

A bicuspid aortic valve (BAV) is a common congenital heart disease, which affects 1-2% of the population. However, the relationship between BAVs and aortic dilation has not been sufficiently elucidated. A total of 241 BAV patients who were referred to this hospital for cardiac surgery over a 4.75-year period were ...

Transcatheter aortic valve implantation has been shown to be an effective and reproducible therapy for severe aortic valve stenosis. Device performance and short-term outcomes of well-deployed prostheses have been extensively investigated and discussed; however, these endpoints have not yet been reported in cases characterized by suboptimal expansion. We describe a ...

PRINCIPLE: Mucopolysaccharidosis is an inborn error of metabolism causing glucosaminoglycans tissue storage. Cardiovascular involvement is variable but contributes significantly towards the morbidity and mortality of the patients. OBJECTIVE: To characterise the echocardiographic abnormalities in children and adolescents with different types of mucopolysaccharidosis. METHOD: Echocardiograms and medical records of 28 patients ...

BACKGROUND: A discrete subaortic membrane cannot only cause left ventricular outflow tract obstruction, but can grow onto the aortic valve leaflets. The late finding of this encroachment is aortic valve insufficiency or stenosis. Echocardiography is used to follow the progression of outflow tract obstruction, but its ability to show subaortic ...

OBJECTIVE: To evaluate the outcomes associated with isolated bicuspid aortic valve (BAV) during childhood and adolescence. STUDY DESIGN: Analysis of a large single institutional cohort of children (n=981) with isolated BAV was undertaken to determine the prevalence of significant ascending aortic dilation and risk of cardiac events. Subjects with known ...

To examine the results of root replacement with aortic valve-sparing in patients with bicuspid aortic valve (BAV) or severe aortic regurgitation (AR). Between 2000 and 2009, 102 patients (mean age 47±17.5 years) underwent aortic valve-sparing procedures for ascending aortic aneurysm or dissection. Patients were assigned to three different groups according ...

Percutaneous aortic valve replacement is an emerging alternative for high surgical risk patients with native aortic valve stenosis. We describe for the first time a valve-in-valve procedure with a CoreValve prosthesis for the treatment of a severely stenotic degenerated aortic bioprosthesis.

The transapical transcatheter aortic valve implantation (TA-TAVI) in degenerated aortic bioprosthesis is an emerging therapy for surgically non-amenable patients. However, the presence of different types of aortic bioprostheses (stented and stentless), available in different sizes (19-27 mm), can be at the origin of important mismatches between the malfunctioning, degenerated aortic ...

OBJECTIVE: We sought to compare the safety and durability of bicuspid aortic valve repair versus replacement with a bioprosthesis. METHODS: We reviewed medical records of patients aged 18 years or older undergoing bicuspid aortic valve repair for aortic regurgitation from 1984 through 2007. We analyzed early outcomes and predictors of ...

Aortic heart valve disease is a growing health problem and a tissue-engineered aortic heart valve could be a promising therapy. In this paper, decellularized porcine aortic heart valve leaflets are used as scaffolds and loaded with growth factor and heparin via layer-by-layer electrostatic deposition (LbL technique) with the final purpose ...

OBJECTIVE: Congenital bicuspid aortic valves frequently cause aortic stenosis or regurgitation. Improved understanding of valve and root biomechanics is needed to achieve advancements in surgical repair techniques. By using imaging-derived data, finite element models were developed to quantify aortic valve and root biomechanical alterations associated with bicuspid geometry. METHODS: A ...

Transcatheter aortic valve replacement is an emerging therapeutic alternative for patients with severe aortic valve stenosis and high surgical risk. The inability to reposition the current prosthesis is a limiting feature of these devices. Here we report on a case of a 74-year-old woman, in which a balloon expandable aortic ...

BACKGROUND: The role of transcatheter aortic valve implantation in the treatment of calcific aortic stenosis is evolving. Immediate and long-term echocardiographic findings are poorly reported. METHODS: Eighty-eight patients in whom surgical aortic valve replacement was contraindicated were studied before and 1 and 7 days, 1 month, and 1 and 2 ...

Currently percutaneous aortic valve replacement (PAVR) is indicated for patients at high surgical risk or for inoperable patients. Preprocedural evaluation is crucial to select the patients who will benefit the most and have the procedure done safely. This review will focus on risk assessment and the value of the available ...

Periodontitis may be a risk factor for atherosclerosis and coronary heart disease. The influence of periodontal pathogens in cardiovascular diseases needs further investigation. Therefore, the aims of this clinical study are: to test the presence of periodontal bacteria DNA in aortic valves and to assess the concomitant presence of the ...

Aortic recoarctation may be difficult to manage, especially in patients with the need for additional surgical interventions. We describe the case of a 45-year-old man with grown-up congenital heart disease, presenting with recoarctation after initial anatomic repair with a prosthetic graft at the age of 16 years. Further examination revealed ...

OBJECTIVE: Aortic cusp extension valvuloplasty is increasingly used in the management of children and adolescents with aortic stenosis or regurgitation. The durability of this approach and the freedom from valve replacement are not well defined. A study was undertaken to investigate outcomes. METHODS: From July 1987 to November 2008, 142 ...

Chronic thrombosis of the Carpentier-Edwards SAV porcine aortic bioprosthesis is a very rare complication.We present the case of an 80-year-old male patient with dyspnoea NYHA class III 30 months after coronary artery bypass grafting and aortic valve replacement. Echocardiography showed an increased gradient over the bioprosthesis and blockage of the ...

BACKGROUND: Percutaneous aortic valve implantation (PAVI) is a procedure gaining popularity and becoming more widely used for the treatment of patients with severe aortic stenosis who are at high risk for surgery. Here we show, for the first time, that a successful and complete elimination of both valvular and subvalvular ...