Enlargement of the aortic annulus with glutaraldehyde-fixed bovine pericardium during aortic valve replacement
BACKGROUND AND AIMS OF THE STUDY: Aortic valve replacement in patients with a small aortic annulus may represent a surgical challenge. We have evaluated a simplified technique to enlarge the aortic annulus which consists of extending the aortotomy incision to divide the commissure between the left and non-coronary cusps into the interleaflet triangle without opening the left atrium.
METHODS: This technique was used in 16 patients (15 women, one man; mean age 66 +/- 9 years) who underwent aortic valve replacement between August 1994 and February 1996. Aortic stenosis was the predominant valvular lesion. A mechanical prosthesis was implanted in 13 patients (81%) (21 mm in six, 23 mm in seven) while three received a bioprosthesis (21 mm in one, 23 mm in two). In all patients it was possible to insert a prosthesis at least one size larger than the original aortic annulus diameter.
RESULTS: There were no operative deaths and no late deaths. Mean follow up was 20 +/- 6 months (range: 12 to 30 months). Echocardiographic controls at 12 months postoperatively showed no evidence of periprosthetic leaks or mitral regurgitation. Comparison with preoperative data showed no significant variations of mean aortic diameter at the sinus level (30.7 +/- 2.2 mm versus 31.3 +/- 2.6 mm) or at the sinotubular junction (33.6 +/- 2.7 mm versus 34.3 +/- 2.9 mm) (p = NS). Significant reduction of left ventricular mass was observed (314 +/- 57 g versus 260 +/- 45 g; p < 0.001).
CONCLUSIONS: This technique is simple, reproducible and effective in allowing adequate enlargement of the aortic annulus and provides excellent clinical and hemodynamic results. Glutaraldehyde-fixed bovine pericardium used as a patch material showed no tendency to aneurysmal dilatation with progression of time at a maximum follow up of 30 months.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
1998 |
|---|---|
| Erschienen: |
1998 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
|---|---|
| Enthalten in: |
The Journal of heart valve disease - 7(1998), 3 vom: 18. Mai, Seite 299-304 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bortolotti, U [VerfasserIn] |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 25.09.1998 Date Revised 21.11.2013 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM09591742X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM09591742X | ||
| 003 | DE-627 | ||
| 005 | 20231222102748.0 | ||
| 007 | tu | ||
| 008 | 231222s1998 xx ||||| 00| ||eng c | ||
| 028 | 5 | 2 | |a pubmed24n0320.xml |
| 035 | |a (DE-627)NLM09591742X | ||
| 035 | |a (NLM)9651843 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bortolotti, U |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Enlargement of the aortic annulus with glutaraldehyde-fixed bovine pericardium during aortic valve replacement |
| 264 | 1 | |c 1998 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 25.09.1998 | ||
| 500 | |a Date Revised 21.11.2013 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND AND AIMS OF THE STUDY: Aortic valve replacement in patients with a small aortic annulus may represent a surgical challenge. We have evaluated a simplified technique to enlarge the aortic annulus which consists of extending the aortotomy incision to divide the commissure between the left and non-coronary cusps into the interleaflet triangle without opening the left atrium | ||
| 520 | |a METHODS: This technique was used in 16 patients (15 women, one man; mean age 66 +/- 9 years) who underwent aortic valve replacement between August 1994 and February 1996. Aortic stenosis was the predominant valvular lesion. A mechanical prosthesis was implanted in 13 patients (81%) (21 mm in six, 23 mm in seven) while three received a bioprosthesis (21 mm in one, 23 mm in two). In all patients it was possible to insert a prosthesis at least one size larger than the original aortic annulus diameter | ||
| 520 | |a RESULTS: There were no operative deaths and no late deaths. Mean follow up was 20 +/- 6 months (range: 12 to 30 months). Echocardiographic controls at 12 months postoperatively showed no evidence of periprosthetic leaks or mitral regurgitation. Comparison with preoperative data showed no significant variations of mean aortic diameter at the sinus level (30.7 +/- 2.2 mm versus 31.3 +/- 2.6 mm) or at the sinotubular junction (33.6 +/- 2.7 mm versus 34.3 +/- 2.9 mm) (p = NS). Significant reduction of left ventricular mass was observed (314 +/- 57 g versus 260 +/- 45 g; p < 0.001) | ||
| 520 | |a CONCLUSIONS: This technique is simple, reproducible and effective in allowing adequate enlargement of the aortic annulus and provides excellent clinical and hemodynamic results. Glutaraldehyde-fixed bovine pericardium used as a patch material showed no tendency to aneurysmal dilatation with progression of time at a maximum follow up of 30 months | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Glutaral |2 NLM | |
| 650 | 7 | |a T3C89M417N |2 NLM | |
| 700 | 1 | |a Scioti, G |e verfasserin |4 aut | |
| 700 | 1 | |a Milano, A |e verfasserin |4 aut | |
| 700 | 1 | |a Nardi, C |e verfasserin |4 aut | |
| 700 | 1 | |a Tartarini, G |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of heart valve disease |d 1997 |g 7(1998), 3 vom: 18. Mai, Seite 299-304 |w (DE-627)NLM012658421 |x 0966-8519 |7 nnns |
| 773 | 1 | 8 | |g volume:7 |g year:1998 |g number:3 |g day:18 |g month:05 |g pages:299-304 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 7 |j 1998 |e 3 |b 18 |c 05 |h 299-304 | ||