By Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer
The surgical result of bioprosthetic aortic valve alternative within the Nineteen Sixties and Nineteen Seventies weren't very passable. the hunt for the perfect alternative for the diseased aortic valve led Donald Ross to advance the concept that of the aortic allograft in 1962 and the pulmonary autograft in 1967 for subcoronary implantation, and later, in 1972, as a whole root for changing the aortic root within the contaminated aortic valve with a root abscess. The aortic al- graft and pulmonary autograft surgeries have been revo- tionary within the heritage of cardiac valve surgical procedure within the final m- lennium simply because they compete good with the bioprosthesis, are nonthrombogenic (thus, requiring no postoperative anticoa- lation), are proof against an infection, repair the anatomic devices of the aortic or pulmonary outflow tract, and provide unimpeded blood move and perfect hemodynamics, giving sufferers a b- ter analysis and caliber of existence. surgical procedure for congenital, degenerative, and inflammatory aortic valve and root illnesses has now reached a excessive point of adulthood; but an incredible valve for valve substitute isn't to be had. The- fore, surgeons are focusing their talents and their medical and s- entific wisdom on optimizing the technical artistry of val- sparing tactics.
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Edwards SAPIENTM transcatheter heart valve 33 34 z J. Kempfert et al. to be implanted in a strictly subcoronary position. The valve within a steel stent is anchored within the aortic annulus by active ballooning of the valve stent. The SAPIENTM system is at present the only commercially available device for transapical aortic valve implantation (TA-AVI) but can also be deployed using the retrograde transfemoral approach (TF-AVI). Patient selection z Risk assessment According to the literature, advanced age alone is not sufficient to deem a patient at high-risk for AVR .
Indications Indications for aortic valve replacement (AVR) were determined by a joint task force of the American College of Cardiology (ACC) and the American Heart Association (AHA) in 1998 and were updated in 2008 . In summary, AVR is indicated in all symptomatic patients with severe AS and in patients with asymptomatic severe AS undergoing cardiac surgery for other reasons. Many cardiac surgery centers have made it their practice to perform AVR along with concomitant cardiac surgery in cases of moderate AS, since the disease is known to progress over time .
J Am Coll Cardiol 50(1):69–76. Epub 2007 Jun 6 17. Haas PC, Krajcer Z, Diethrich EB (1999) Closure of large percutaneous access sites using the Prostar XL Percutaneous Vascular Surgery device. J Endovasc Surg 6(2):168–170 18. Piazza N, Grube E, Gerckens U, den Heijer P, Linke A, Luha O, Ramondo A Ussia G, Wenaweser P, Windecker S, Laborde JC, de Jaegere P, Serruys P (2008) Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) CoreValve ReValving System: results from the multicentre, expanded evaluation registry 1-year following CE mark approval.
Aortic Root Surgery: The Biological Solution by Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer