Anatomy of the Aortic Valve and Root - A (Pediatric) Cardiac Surgeon s View
|
|
|
- Loren Blankenship
- 6 years ago
- Views:
Transcription
1 Anatomy of the Aortic Valve and Root - A (Pediatric) Cardiac Surgeon s View Markus K. Heinemann Klinik für Herz-, Thorax- und Gefäßchirurgie Universitätsmedizin Mainz
2 X X X X X X X X 2?
3 Conflicts of Interest (?) I am a surgeon for congenital heart disease by training. Pediatric cardiac surgeons tend to be peculiar. Their views may be somewhat idiosyncratic. Fortunately, I have also done research and published on aortic dissection. So it might be worth staying in the room after all. Don t say you haven t been warned!
4 What exactly is the aortic root? Wikipedia (what else?): The aortic root is the portion of the aorta beginning at the aortic annulus and extending to the sinotubular junction. It is sometimes regarded as a separate entity from the rest of the ascending aorta. Between each commissure of the aortic valve and opposite the cusps of the aortic valve, three small dilatations are called the aortic sinuses. The sinotubular junction is the point in the ascending aorta where the aortic sinuses end and the aorta becomes a tubular structure.
5 What shall we focus on, then? Anulus (the enigma) Cusps (aka Leaflets ) Sinus (yes, that s the plural) Coronaries (lest we forget) Ascending Aorta (where the root ends)
6 Anulus Latin: anulus, pl.: anuli = small ring Why we should have an annulus, but simply an anus nobody knows. A: complex, 3-dimensional, crown-shaped structure (surgical) B: diameter at base of aortic root ( unanatomical, reference measure) from: Pershad A, Stone D, Morris MF, Fang K, Gellert G Aortic annulus measurement and relevance to successful TAVR J Interv Cardiol Jun;26(3):302-9.
7 Anulus some harsh words Descriptions of the aortic root over the years have been BEDEVILED by accounts of a valve anulus. There are at least 2 RINGS within the root we describe the current problems which have arisen due to INDISCRIMINATE descriptions of a NONEXISTENT anulus. Loukas M, Bilinsky E, Bilinsky S, Blaak C, Tubbs RS, Anderson RH. The anatomy of the aortic root. Clinical Anatomy 2014;27:748-56
8 Anular Enlargement Classic Surgery (AVR) To prevent patient-prosthesis mismatch Simple and efficient The incision is directed toward the mid-mitral line (an imaginary line that divides the anterior leaflet into two equal halves), down to the level where the roof of the left atrium is attached to the fibrous curtain. A teardrop-shaped pericardial patch is sutured to this extended aortotomy with a continuous 4-0 polypropylene suture. Sommers KE, David TE. AVR with patch enlargement of the aortic annulus. Ann Thor Surg 1997;63:
9 Anuloplasty If you tighten your belt you lift up your trousers Anuloplasty increases coaptation height Lansac E et al. An external open ring for isolated aortic valve repair. Multimed Man Cardiothorac Surg 2011
10 Anuloplasty Decreasing anulus diameter increases coaptation height and area Measuring effective coaptation height helps to judge valve performance after reconstruction Marom G, Haj-Ali R, Rosenfeld M, Schäfers HJ, Raanani E. Aortic root numeric model: Annulus diameter prediction of effective height and coaptation in post aortic valve repair. J Thorac Cardiovasc Surg 2013; 145:
11 Cusps EMBRYOLOGY Fusion of outflow tract cushions Appearance of intercalated cushions Excavation of their distal margins Ingrowth of non-myocardial tissue for sinus Spicer DE, Bridgeman JM, Brown NA, Mohun TJ, Anderson RH. The anatomy and development of the cardiac valves. Cardiol Young 2014; 24:
12 Cusps (anatomical) Usually 3 Sometimes 2 ( bicuspid ) stenosis, ascending aortic aneurysm Rarely 4 (quadricuspid) regurgitation, pediatric population or Syrian hamsters López-García A, Fernández MC, Durán AC, Sans-Coma V, Fernández B. Quadricuspid aortic valves in Syrian hamsters and their formation according to current knowledge on valvulogenesis. Japanese Journal of Veterinary Research 2015; 63: 37-43
13 Cusps (mathematical) Cusp geometric height (gh) higher than presumed?! Non-fused cusps in bicuspids larger than in tricuspids In case of retraction forget repair Schäfers HJ, Schmied W, Marom G, Aicher D. Cusp height in aortic valves. J Thorac Cardiovasc Surg 2013;146: Labrosse MR, Beller CJ, Robicsek F, Thubrikar MJ. Geometric modeling of functional trileaflet aortic valves: Development and clinical applications J Biomechanics 2006; 39:
14 Sinus = bay, bulge Plural: Sinus (U-declination) the area behind the cusps providing room for the cusps sort of Hidden Valleys Antonio Maria Valsalva ( ) anatomist and surgeon
15 Sinus Green sinotubular junction Blue mid-sinus level (widest) Red basal cusp attachment Red dot echo annulus Loukas M, Bilinsky E, Bilinsky S, Blaak C, Tubbs RS, Anderson RH. The anatomy of the aortic root. Clinical Anatomy 2014;27:748-56
16 Sinus Largest diameter of root anyway Pear / onion in connective tissue disease (Marfan etc) Dilation in bicuspids Enlarged in cyanotic CHD with limited pulmonary blood flow (ToF!) redirection towards one outlet already in fetal life root aneurysm Kim TS, Na CY, Baek JH, Yang JS. Aortic root and ascending aortic aneursym in an adult with a repaired tetralogy of Fallot. Korean J Thorac Cardiovasc Surg 2011;44:292-3
17 Sinus Kirklin, Barrat-Boyes, Cardiac Surgery Loukas M, Bilinsky E, Bilinsky S, Blaak C, Tubbs RS, Anderson RH. The anatomy of the aortic root. Clinical Anatomy 2014;27:748-56
18 Sinus Valsalva Aneurysm
19 Coronary Arteries Part of the root Remember the Alamo (here: early TAVI experience) Always in the way Make the David / Yacoub procedures tedious / unpopular May have abnormal pattern
20 Coronary Arteries EMBRYOLOGY (Oh no not you again!) Observations by Raymond Vieussens ( ) Ingrowth rather than Outgrowth Debated by RH Anderson (of course) ALCAPA - how can it happen? Bogers AJJC, Gittenberger-de Groot AC, Dubbeldam JA, Huysmans HA.The inadequacy of existing theories on development of the proximal coronary arteries and their connexions with the arterial trunks. Int J Cardiol 1988;20: Spicer DE, Henderson DJ, Chaudhry B, Mohun DJ, Anderson RH. The anatomy and development of normal and abnormal coronary arteries. Cardiol Young 2015;25:
21 Ascending Aorta Starts at Sino-tubular junction Is the first really tubular part of the aorta Contains more elastic fibers than the rest and is therefore happy to dilate Langer F, Aicher D, Kissinger A, Wendler O, Lausberg H, Fries R, Schäfers HJ. Aortic valve repair using a differentiated strategy. Circulation 2004;110:II67 II73 May be replaced supracoronarily (if justified) but is often inseparable from its root
22 Ascending Aorta Aortic Dissection Type A Ascending aortic aneurysm Dilation in bicuspids Extension of root pathology Children: supravalvular aortic stenosis (media)! (Williams-Beuren syndrome, aortoplasty Doty, Brom) Stamm C, Friehs I, Ho SY, Moran AM, Jonas RA, del Nido PJ. Congenital supravalvar aortic stenosis. A simple lesion? EurJCTS 2001;19:
23 Ascending Aorta More MATHS : Tirone s Rule for graft diameter in ascending aortic replacement 1. Take circumference of sino-tubular junction 2. subtract diameter at brachiocephalic trunk take-off 3. multiply by zero 4. and add 28. (CFstj Dbrc) X = Dgraft
24 Luckily, Life s not just mathematics Enjoy the course!
State of the art in reconstruction of the ascending aorta with or without valve reconstruction
State of the art in reconstruction of the ascending aorta with or without valve reconstruction PD Dr Diana Aicher Universitätskliniken des Saarlandes Homburg/Germany ESBV Straßbourg, May 10 2013 Background
Functional anatomy of the aortic root. ΔΡΟΣΟΣ ΓΕΩΡΓΙΟΣ Διεσθσνηής Καρδιοθωρακοτειροσργικής Κλινικής Γ.Ν. «Γ. Παπανικολάοσ» Θεζζαλονίκη
Functional anatomy of the aortic root ΔΡΟΣΟΣ ΓΕΩΡΓΙΟΣ Διεσθσνηής Καρδιοθωρακοτειροσργικής Κλινικής Γ.Ν. «Γ. Παπανικολάοσ» Θεζζαλονίκη What is the aortic root? represents the outflow tract from the LV provides
How to Perform a Valve Sparing Root Replacement Joseph S. Coselli, M.D.
How to Perform a Valve Sparing Root Replacement Joseph S. Coselli, M.D. AATS International Cardiovascular Symposium 2017 Session 6: Technical Aspects of Open Surgery on the Aortic Valve Sao Paulo, Brazil
Aortic Valve Repair a Modular and Geometric Approach. H.-J. Schäfers Dept. of Thoracic and Cardiovascular Surgery University Hospital of Saarland
Aortic Valve Repair a Modular and Geometric Approach H.-J. Schäfers Dept. of Thoracic and Cardiovascular Surgery University Hospital of Saarland 12.09.2018 Limitations: Purely echocardiographic, does not
Aortic valve repair is an accepted option for aortic valve
Complex Aortic Valve Disease in Children Christopher W. Baird, MD,* and Pedro J. del Nido, MD Aortic valve repair is an accepted option for aortic valve pathologic conditions in children and young adults.
The Bicuspid AV Surgical Conisiderations
The Bicuspid AV Surgical Conisiderations Ehud Raanani, MD Cardiothoracic Surgery, Sheba Medical Center Sackler School of Medicine, Tel Aviv University MAY 15, 2014 Homburg BAV Repair Congenital variations
14 Valvular Stenosis
14 Valvular Stenosis 14-1. Valvular Stenosis unicuspid valve FIGUE 14-1. This photograph shows severe valvular stenosis as it occurs in a newborn. There is a unicuspid, horseshoe-shaped leaflet with a
Aortic Valve Repair - Alternative to Replacement
Aortic Valve Repair - Alternative to Replacement Seite 1 Dept. of Thoracic and Cardiovascular Surgery University Hospital of Saarland Homburg/ Saar Germany Seite 2 Aortic Valve - Historic Repair Attempts
An anterior aortoventriculoplasty, known as the Konno-
The Konno-Rastan Procedure for Anterior Aortic Annular Enlargement Mark E. Roeser, MD An anterior aortoventriculoplasty, known as the Konno-Rastan procedure, is a useful tool for the cardiac surgeon. Originally,
SURGICAL INTERVENTION IN AORTOPATHIES ZOHAIR ALHALEES, MD RIYADH, SAUDI ARABIA
SURGICAL INTERVENTION IN AORTOPATHIES ZOHAIR ALHALEES, MD RIYADH, SAUDI ARABIA In patients born with CHD, dilatation of the aorta is a frequent feature at presentation and during follow up after surgical
Sparing aortic valve techniques
Surgical Technique Sparing aortic valve techniques Rubén Álvarez-Cabo Cardiac Surgery Department, Heart Area, Central University Hospital of Asturias (HUCA), Oviedo, Spain Correspondence to: Rubén Álvarez-Cabo.
Transoesophageal echocardiography and decision making in valve surgery
Transoesophageal echocardiography and decision making in valve surgery Intraoperative evaluation of the surgical results in aortic valve / root surgery Catherine Szymanski Disclosures None Sino-tubular
Aortic valve repair: When and how to employ this novel approach?
Aortic valve repair: When and how to employ this novel approach? Konstadinos A Plestis, MD System Chief of Cardiac Thoracic and Vascular Surgery Main Line Health Care System Professor Sidney Kimmel Medical
Indications and Late Results of Aortic Valve Repair
Indications and Late Results of Aortic Valve Repair Prof. Gebrine El Khoury Department of Cardiovascular and Thoracic Surgery Cliniques St. Luc Brussels, Belgium Aortic Valve Repair Question # 1 Can the
Surgical Procedures and Complications
Radiological Society of North America, RSNA 2013 Refresher Course Program: Vascular Track Surgical Procedures and Complications Learning objectives Outline RC 112 : Key Concepts: Surgical Procedures and
Anatomy determines the close vicinity of the sinuses of
Aortic Valve Reimplantation According to the David Type I Technique Matthias Karck, MD, and Axel Haverich, MD Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Operative Strategy. Operative Technique
Domingo Liotta, M.D.; Christian Cabrol, M.D; Miguel del Rio, M.D; Armando Diluch, M.D; Adriano Malusardi, M.D. Figure 11 Acute dissected aortic root and ascending aorta with valvular regurgitation. -Replacement
Joseph E. Bavaria, M.D. Roberts Measy Professor and Vice Chief CardioVascular Surgery Director: Thoracic Aortic Surgery Program University of
Joseph E. Bavaria, M.D. Roberts Measy Professor and Vice Chief CardioVascular Surgery Director: Thoracic Aortic Surgery Program University of Pennsylvania, USA North American Valve Repair, Philadelphia
Technical consideration of aquiring and analyzing 3D TEE volume data sets (EchoPac ) Phasic changes of the aortic root throughout the cardiac cycle
Technical consideration of aquiring and analyzing 3D TEE volume data sets (EchoPac ) Phasic changes of the aortic root throughout the cardiac cycle Specific application in aortic regurgitation and aortic
Reconstruction of the Aortic Valve and Root A Practical approach Failures after aortic valve repair. Diana Aicher. September 16 th -18 th 2015
Reconstruction of the Aortic Valve and Root A Practical approach Failures after aortic valve repair Diana Aicher September 16 th -18 th 2015 Classification of failures- root repair 51/810 acute/ intraoperative
Valve-sparing aortic root replacement in patients with Marfan syndrome the Homburg experience
Masters of Cardiothoracic Surgery Valve-sparing aortic root replacement in patients with Marfan syndrome the Homburg experience Ulrich Schneider, Tristan Ehrlich, Irem Karliova, Christian Giebels, Hans-Joachim
The Bicuspid AV Surgical Considerations
The Bicuspid AV Surgical Considerations Ehud Raanani, MD Cardiothoracic Surgery, Sheba Medical Center Sackler School of Medicine, Tel Aviv University September 12, 2014 Homburg BAV Repair Congenital variations
Joseph E. Bavaria, M.D. Roberts Measy Professor and Vice Chief CardioVascular Surgery Director: Thoracic Aortic Surgery Program University of
Joseph E. Bavaria, M.D. Roberts Measy Professor and Vice Chief CardioVascular Surgery Director: Thoracic Aortic Surgery Program University of Pennsylvania, USA AVRS Philadelphia Sept 2016 Pictures courtesy
2 nd AVRS 2016: Nimesh D. Desai, M.D., Ph.D. Co Director, Aortic and Vascular Center for Excellence University of Pennsylvania
2 nd AVRS 2016: Nimesh D. Desai, M.D., Ph.D. Co Director, Aortic and Vascular Center for Excellence University of Pennsylvania Knowing what to Do Know what NOT to Do The Exquisite art of Timing. or is
Introduction. Aortic Valve. Outflow Tract and Aortic Valve Annulus
Chapter 1: Surgical anatomy of the aortic and mitral valves Jordan RH Hoffman MD, David A. Fullerton MD, FACC University of Colorado School of Medicine, Department of Surgery, Division of Cardiothoracic
The stentless bioprosthesis has many salient features that
Aortic Valve Replacement with the Medtronic Freestyle Xenograft Using the Subcoronary Implantation Technique D. Michael Deeb, MD The stentless bioprosthesis has many salient features that make it an attractive
New Technique for Aortic Valve Functional Annulus Reshaping Using a Handmade Prosthetic Ring
New Technique for Aortic Valve Functional Annulus Reshaping Using a Handmade Prosthetic Ring Khalil Fattouch, MD, PhD, Roberta Sampognaro, MD, Giuseppe Speziale, MD, and Giovanni Ruvolo, MD Department
Reconstructive surgery of the aortic root
Reconstructive surgery of the aortic root Reconstructive surgery of the aortic root Academician d-r Zan Mitrev MDFETCS Special hospital for surgery Fillip II Skopje - Macedonia february, 2011 Reconstructive
Lessons From The Computer Model and How We Do Root Replacement
Lessons From The Computer Model and How We Do Root Replacement Ehud Raanani, MD Cardiac Surgery Leviev Cardiothoracic and Vascular Center Sheba Medical Center Sackler School of Medicine, Tel Aviv University
S. Bruce Greenberg, MD FNASCI and President, NASCI Professor of Radiology and Pediatrics University of Arkansas for Medical Sciences
S. Bruce Greenberg, MD FNASCI and President, NASCI Professor of Radiology and Pediatrics University of Arkansas for Medical Sciences No financial disclosures Aorta Congenital aortic stenosis/insufficiency
Aortic root enlargement is an invaluable surgical technique
Aortic Root Enlargement in the Adult Christopher M. Feindel, MD, CM, FRCS(C) Aortic root enlargement is an invaluable surgical technique with which every cardiac surgeon performing aortic valve replacement
Anatomy of aortic valve and root
Anatomy of aortic valve and root Emmanuel Lansac, Isabelle Di Centa Cardiac Surgery Institut Mutualiste Montsouris, Paris, France The aortic valve : a passive or dynamic structure? Leonardo da Vinci 1508
Bicuspid Aortic Valve: Only Valvular Disease? Artur Evangelista
Bicuspid Aortic Valve: Only Valvular Disease? Artur Evangelista Bicuspid aortic valve BAV is not only a valvulogenesis disorder but also represent coexisting aspects of a genetic disorder of the aorta
In the past two decades the development of valvesparing
Valve-Sparing Aortic Root Reconstruction Using In Situ Three-Dimensional Measurements Andras C. Kollar, MD, PhD, Scott D. Lick, MD, and Vincent R. Conti, MD Division of Cardiothoracic Surgery, Department
Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results
Short Communication Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri,
Aortic valve repair: Techniques and Pitfalls. Allan Stewart, MD Columbia University Medical Center New York, NY
Aortic valve repair: Techniques and Pitfalls Allan Stewart, MD Columbia University Medical Center New York, NY Take Away Points 1. Valve anatomy is essential to assess repair 2. Unique Decisions with Aneurysm/AI
Patrick O. Myers, MD, 1,2 Pedro J. del Nido, MD, 1 Sitaram M. Emani, MD, 1 Gerald R. Marx, MD, 3 Christopher W. Baird, MD 1
Valve-Sparing Aortic Root Replacement and Remodeling with Complex Aortic Valve Reconstruction in Children and Young Adults with Moderate or Severe Aortic Regurgitation Patrick O. Myers, MD, 1,2 Pedro J.
Two semilunar valves. Two atrioventricular valves. Valves of the heart. Left atrioventricular or bicuspid valve Mitral valve
The Heart 3 Valves of the heart Two atrioventricular valves Two semilunar valves Right atrioventricular or tricuspid valve Left atrioventricular or bicuspid valve Mitral valve Aortic valve Pulmonary valve
AORTIC ROOT RECONSTRUCTION WITH PRESERVATION OF NATIVE AORTIC VALVE AND SINUSES IN AORTIC ROOT DILATATION WITH AORTIC REGURGITATION
AORTIC ROOT RECONSTRUCTION WITH PRESERVATION OF NATIVE AORTIC VALVE AND SINUSES IN AORTIC ROOT DILATATION WITH AORTIC REGURGITATION Jacques A. M. van Son, MD, PhD Roberto Battellini, MD Marco Mierzwa,
Results of Aortic Valve Preservation and Repair
Results of Aortic Valve Preservation and Repair Department of Cardiothoracic and Vascular Surgery Cliniques Universitaires St. Luc Brussels, Belgium Gebrine Elkhoury Institutional experience in AV preservation
Surgery for Acquired Cardiovascular Disease. Aortic root remodeling: Ten-year experience with 274 patients
Aortic root remodeling: Ten-year experience with 274 patients Diana Aicher, MD, Frank Langer, MD, Henning Lausberg, MD, Benjamin Bierbach, MD, and Hans-Joachim Schäfers, MD Objectives: Dilatation of the
The need for right ventricular outflow tract reconstruction
Polytetrafluoroethylene Bicuspid Pulmonary Valve Implantation James A. Quintessenza, MD The need for right ventricular outflow tract reconstruction and pulmonary valve replacement is increasing for many
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve
Anatomy of left ventricular outflow tract'
Anatomy of left ventricular outflow tract' ROBERT WALMSLEY British Heart Journal, 1979, 41, 263-267 From the Department of Anatomy and Experimental Pathology, The University, St Andrews, Scotland SUMMARY
Aortic root reconstructive surgery - new created technique for aortic stenosis
Aortic root reconstructive surgery - new created technique for aortic stenosis Reconstructive surgery of the aortic root Academician d-r Zan Mitrev, T.Anguseva, E.Stoicovski, E Idoski Special hospital
Congenital supravalvar aortic stenosis (SVAS) is the least
Brom Repair for Supravalvar Aortic Stenosis Max B. Mitchell, MD,* and Steven P. Goldberg, MD Congenital supravalvar aortic stenosis (SVAS) is the least common form of left ventricular outflow tract (LVOT)
Aortic valve insufficiency may be caused by abnormalities
Reconstruction of the Ascending Aorta and Aortic Root: Experience in 45 Consecutive Patients Gebrine A. El Khoury, MD, Malcolm J. Underwood, MD, David Glineur, MD, David Derouck, MD, and Robert A. Dion,
Anatomy of aortic valve and root Emmanuel Lansac MD PhD
Anatomy of aortic valve and root Emmanuel Lansac MD PhD Cardiac Surgery Institut Mutualiste Montsouris, Paris, France The aortic valve : a passive or dynamic structure? Leonardo da Vinci 1508 Quadr Anat
New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology
New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor Cardiothoracic Radiology Disclosure I have no disclosure pertinent to this presentation.
The modified Konno procedure, or subaortic ventriculoplasty,
Modified Konno Procedure for Left Ventricular Outflow Tract Obstruction David P. Bichell, MD The modified Konno procedure, or subaortic ventriculoplasty, first described by Cooley and Garrett in1986, 1
Mid-term results in patients having tricuspidization of the quadricuspid aortic valve
Song et al. Journal of Cardiothoracic Surgery 2014, 9:29 RESEARCH ARTICLE Open Access Mid-term results in patients having tricuspidization of the quadricuspid aortic valve Meong Gun Song 1, Hyun Suk Yang
The Journal of Thoracic and Cardiovascular Surgery
Accepted Manuscript Love the Root Not the Flowers Everyone Sees Tomasz A. Timek, MD PhD, Clinical Associate Professor PII: S0022-5223(18)31205-4 DOI: 10.1016/j.jtcvs.2018.04.068 Reference: YMTC 12941 To
3 Aortopulmonary Window
0 0 0 0 0 Aortopulmonary Window Introduction Communications between the ascending aorta and pulmonary artery constitute a spectrum of malformations which is collectively designated aortopulmonary window,
Surgical Management of TOF in Adults. Dr Flora Tsang Associate Consultant Department of Cardiothoracic Surgery Queen Mary Hospital
Surgical Management of TOF in Adults Dr Flora Tsang Associate Consultant Department of Cardiothoracic Surgery Queen Mary Hospital Tetralogy of Fallot (TOF) in Adults Most common cyanotic congenital heart
Valve-sparing versus composite root replacement procedures in patients with Marfan syndrome
Masters of Cardiothoracic Surgery Valve-sparing versus composite root replacement procedures in patients with Marfan syndrome Joseph S. Coselli 1,2,3, Scott A. Weldon 1,4, Ourania Preventza 1,2,3, Kim
Repair for Aortic Regurgitation: is it durable?
Repair for Aortic Regurgitation: is it durable? Gébrine El Khoury Cliniques Universitaires St-Luc, IREC, UCL, Brussels, Belgium AATS 95 th Annual Meeting 25-29 April, Seattle Aorrtic valve repair the basics
Adult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
Reconstruction of the Aortic Valve and Root A Practical approach Why and when to repair the aortic valve. Diana Aicher. September 16 th - 18 th 2015
Reconstruction of the Aortic Valve and Root A Practical approach Why and when to repair the aortic valve Diana Aicher September 16 th - 18 th 2015 Why repair the aortic valve? Aortic Valve Replacement
Repair of the aortic valve in patients with insufficiency and aortic root aneurysm
Surgery for Acquired Heart Disease Repair of the aortic valve in patients with insufficiency and aortic root aneurysm aortic Patients with aneurysms of the ascending aorta or aortic root frequently have
S. Bert Litwin, MD. Preface
Preface Because of the wide variety of anomalies encountered in congenital heart surgery, a broad understanding of the pathologic anatomy of defects is vitally important to the surgeon. More than in many
chap ter 01 General introduction
chap ter 01 General introduction General introduction General introduction The aorta is not simply a tube or conduit, but a highly complex part of the vascular tree, originating from the left ventricular
Adult Congenital Heart Disease: What All Echocardiographers Should Know Sharon L. Roble, MD, FACC Echo Hawaii 2016
1 Adult Congenital Heart Disease: What All Echocardiographers Should Know Sharon L. Roble, MD, FACC Echo Hawaii 2016 DISCLOSURES I have no disclosures relevant to today s talk 2 Why should all echocardiographers
An Intra-Annular Hemispherical Annuloplasty Frame for Aortic Valve Repair J. Scott Rankin
An Intra-Annular Hemispherical Annuloplasty Frame for Aortic Valve Repair J. Scott Rankin Centennial Medical Center, Vanderbilt University, Nashville, TN, USA Background and aim of the study: A Hemispherical
Outline. EuroScore II. Society of Thoracic Surgeons Score. EuroScore II
SURGICAL RISK IN VALVULAR HEART DISEASE: WHAT 2D AND 3D ECHO CAN TELL YOU AND WHAT THEY CAN'T Ernesto E Salcedo, MD Professor of Medicine University of Colorado School of Medicine Director of Echocardiography
Disease of the aortic valve is frequently associated with
Stentless Aortic Bioprosthesis for Disease of the Aortic Valve, Root and Ascending Aorta John R. Doty, MD, and Donald B. Doty, MD Disease of the aortic valve is frequently associated with morphologic abnormalities
Aortic Regurgitation in Connective Tissue Disorders Special precautions? Carlos A. Mestres MD PhD FETCS
Aortic Regurgitation in Connective Tissue Disorders Special precautions? Carlos A. Mestres MD PhD FETCS Senior Consultant Department of Cardiovascular Surgery University Hospital Zürich (Switzerland) Extraordinary
The Edge-to-Edge Technique f For Barlow's Disease
The Edge-to-Edge Technique f For Barlow's Disease Ottavio Alfieri, Michele De Bonis, Elisabetta Lapenna, Francesco Maisano, Lucia Torracca, Giovanni La Canna. Department of Cardiac Surgery, San Raffaele
Aortic valve repair is a technique that is gaining popularity
Aortic Valve Repair in Children, Including Pericardial Patch Reconstruction Aditya K. Kaza, MD,* and John A. Hawkins, MD Aortic valve repair is a technique that is gaining popularity in children because
Joseph E. Bavaria, MD
EACTS Master Class on Aortic Valve Repair Joseph E. Bavaria, MD Director, Thoracic Aortic Surgery Program Roberts Measey Professor and Vice Chair of CV Surgery University of Pennsylvania Immediate-Past
The arterial switch operation has been the accepted procedure
The Arterial Switch Procedure: Closed Coronary Artery Transfer Edward L. Bove, MD The arterial switch operation has been the accepted procedure for the repair of transposition of the great arteries (TGA)
The Ross Procedure: Outcomes at 20 Years
The Ross Procedure: Outcomes at 20 Years Tirone David Carolyn David Anna Woo Cedric Manlhiot University of Toronto Conflict of Interest None The Ross Procedure 1990 to 2004 212 patients: 66% 34% Mean age:
Late secondary TR after left sided heart disease correction: is it predictibale and preventable
Late secondary TR after left sided heart disease correction: is it predictibale and preventable Gilles D. Dreyfus Professor of Cardiothoracic surgery Nath J, et al. JACC 2004 PREDICT Incidence of secondary
CARDIAC DEVELOPMENT CARDIAC DEVELOPMENT
CARDIAC DEVELOPMENT CARDIAC DEVELOPMENT Diane E. Spicer, BS, PA(ASCP) University of Florida Dept. of Pediatric Cardiology Curator Van Mierop Cardiac Archive This lecture is given with special thanks to
The Rastelli procedure has been traditionally used for repair
En-bloc Rotation of the Truncus Arteriosus A Technique for Complete Anatomic Repair of Transposition of the Great Arteries/Ventricular Septal Defect/Left Ventricular Outflow Tract Obstruction or Double
Unusual Causes of Aortic Regurgitation. Case 1
Unusual Causes of Aortic Regurgitation Judy Hung, MD Cardiology Division Massachusetts General Hospital Boston, MA No Disclosures Case 1 54 year old female with h/o cerebral aneurysm and vascular malformation
Surgical Management of Supravalvular Aortic Stenosis: Does Brom Three-Patch Technique Provide Superior Results?
Surgical Management of Supravalvular Aortic Stenosis: Does Brom Three-Patch Technique Provide Superior Results? Olivier Metton, MD, Walid Ben Ali, MD, Davide Calvaruso, MD, Damien Bonnet, MD, PhD, Daniel
Coronary Artery from the Wrong Sinus of Valsalva: A Physiologic Repair Strategy
Coronary Artery from the Wrong Sinus of Valsalva: A Physiologic Repair Strategy Tom R. Karl, MS, MD he most commonly reported coronary artery malformation leading to sudden death in children and young
Dr Winnie Sze-Wun Chan. Cardiac Team Deputy Team Head Department of Radiology and Imaging Queen Elizabeth Hospital Hong Kong
Dr Winnie Sze-Wun Chan Cardiac Team Deputy Team Head Department of Radiology and Imaging Queen Elizabeth Hospital Hong Kong Why? Is CT reliable? How to perform the CT study? How to interpret the CT study?
Mitral Valve Disease, When to Intervene
Mitral Valve Disease, When to Intervene Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Current ACC/AHA guideline Stages
BICUSPID AORTIC VALVE. Surgery everytime over 50 mm
EuroGUCH 2017 Lousanne 5-6 May BICUSPID AORTIC VALVE Surgery everytime over 50 mm Alessandro Giamberti, MD Head Congenital Cardiac Surgery Unit IRCCS Policlinico San Donato Bicuspid Aortic Valve (BAV)
Surgical Treatment for Double Outlet Right Ventricle. Masakazu Nakao Consultant, Paediatric Cardiothoracic Surgery
for Double Outlet Right Ventricle Masakazu Nakao Consultant, Paediatric Cardiothoracic Surgery 1 History Intraventricular tunnel (Kawashima) First repair of Taussig-Bing anomaly (Kirklin) Taussig-Bing
Will we face a big problem with the aortic valve/root after ASO?
Will we face a big problem with the aortic valve/root after ASO? Laurence Iserin Unité médico-chirurgicale de Cardiologie Congénitale Adulte Hôpital Universitaire Européen Georges Pompidou APHP, Université
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our
European CMR Certification: LIST OF PROCEDURES FORM
European CMR Certification: LIST OF PROCEDURES FORM Application for: Level 2 Level 3 Candidate is requested to submit a list of 150 (Level 2) or 300 (Level 3) studies reported by her/him as detailed in
Unexpected resolution of first trimester fetal valve stenosis: consequence
Unexpected resolution of first trimester fetal valve stenosis: consequence of developmental remodeling? Gardiner, Helena M. The Fetal Center, Children s Memorial Hermann Hospital, McGovern Medical School,
Anatomy lab -1- Imp note: papillary muscle Trabeculae Carneae chordae tendineae
Anatomy lab -1- Imp note: the arrangement of this sheet is different than the lab recording, it has been arranged in a certain way to make it easier to study. When you open the left ventricle you can see
A lesional classification to standardize surgical management of aortic insufficiency towards valve repair
European Journal of Cardio-thoracic Surgery 33 (2008) 872 880 www.elsevier.com/locate/ejcts A lesional classification to standardize surgical management of aortic insufficiency towards valve repair Emmanuel
Surgical indications in ascending aorta aneurysms: What do we know? Jean-Luc MONIN, MD, PhD. Institut Mutualiste Montsouris, Paris, FRANCE
Surgical indications in ascending aorta aneurysms: What do we know? Jean-Luc MONIN, MD, PhD. Institut Mutualiste Montsouris, Paris, FRANCE Disclosures related to this talk : NONE 2 Clinical case A 40 year-old
Bicuspid aortic valve disease
AORTIC VALVE DISEASE Bicuspid aortic valve disease James C. Lee and Catherine M. Otto Division of Cardiology, University of Washington, Seattle, United State of America Address for correspondence: James
Anatomy of the Heart
Biology 212: Anatomy and Physiology II Anatomy of the Heart References: Saladin, KS: Anatomy and Physiology, The Unity of Form and Function 8 th (2018). Required reading before beginning this lab: Chapter
Regurgitant Lesions. Bicol Hospital, Legazpi City, Philippines July Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA
Regurgitant Lesions Bicol Hospital, Legazpi City, Philippines July 2016 Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA Aortic Insufficiency Valve anatomy and function LVOT and
Aortic Valve Repair: The Brussels Approach Laurent de Kerchove, MD, PhD Cliniques Universitaires St-Luc, IREC, UCL, Brussels, Belgium
Reconstruction of the Aortic Valve and Root: A Practical Approach September 14 th -16 th, Homburg/Saar, Germany Aortic Valve Repair: The Brussels Approach Laurent de Kerchove, MD, PhD Cliniques Universitaires
Severity of AS Degree of AV calcification (? Bicuspid AV), annulus size, & aortic root
The role of Cardiac Imaging modalities in evaluation & selection of patients for Trans-catheter Aortic Valve Implantation Dr.Saeed AL Ahmari Consultant Cardiologist Prince Sultan Cardaic Center, Riyadh
Aortic and mitral valve repair for anterior mitral leaflet perforation caused by severe aortic regurgitation
Case Report on Cardiac Surgery Page 1 of 5 Aortic and mitral valve repair for anterior mitral leaflet perforation caused by severe aortic regurgitation Kristof De Brabandere 1, Jens-Uwe Voigt 2, Stephen
Anatomy of Atrioventricular Septal Defect (AVSD)
Surgical challenges in atrio-ventricular septal defect in grown-up congenital heart disease Anatomy of Atrioventricular Septal Defect (AVSD) S. Yen Ho Professor of Cardiac Morphology Royal Brompton and
Aneurysms of the proximal ascending aorta represent a
Ascending Aortic Replacement With Aortic Valve Reimplantation Wolfgang Harringer, MD; Klaus Pethig, MD; Christian Hagl, MD; Gerd P. Meyer, MD; Axel Haverich, MD Background Reimplantation of the native,
Overview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan
Overview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan Degenerative MR is not Functional MR 2o - Functional MR : Ventricular Problem!!