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Aortic valve sparing techniques in ascending aortic aneurysm and dissection : Immediate and early results

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Cardiothoracic Surgery

Advisors

Badr, Saeid A., Rushdi, Amr M., Muhammad, Alaa-El-Din F.

Authors

El-Sharqawi, Ahmad Abdel-Aziz

Accessioned

2017-07-12 06:42:23

Available

2017-07-12 06:42:23

type

M.D. Thesis

Abstract

Background: Valve sparing aortic root reconstruction techniques had been popularized in the last decades over the classic root replacement (Bentall) procedure because preservation of the patient’s native aortic valve allows for better hemodynamics and left ventricular performance, lesser risk of endocarditis and avoidance of life long anticoagulation. Objective: The aim of this study is to evaluate the early results of aortic valve sparing reimplantation technique in patients with ascending aortic aneurysm and dissection. Patients and Methods: This is a prospective study carried out from January 2008 to January 2011 at Kasr El-Aini and Dar Al-Fouad Hospitals, where 50 patients (32 male and 18 female, with mean age of 53 ± 13 years) with aortic root diseases and significant aortic regurgitation were operated upon using aortic valve reimplantation (David) technique and studied for aortic valve competence. The patients include 11 cases of aortic dissections and 39 cases of ascending aortic aneurysms. 5 patients had Marfan syndrome and 5 had bicuspid aortic valve. Results: Postoperative echocardiographic data showed marked improvement as regards left ventricular dimensions and degree of aortic incompetence. Moderate (grade II) aortic regurgitation was 8% at 1 year with 100% freedom from reoperation due to aortic valve related problems. Early postoperative mortality was 2%. No neurological or renal complications. Conclusion: Valve sparing reimplantation (David) technique has good results regarding durability of aortic repair in managing patients with aortic root diseases. Special considerations are required for patients with bicuspid aortic valve and Marfan syndrome where the combination of cuspal repair with aortic root reconstruction gives better outcome.

Issued

1 Jan 2012

DOI

http://dx.doi.org/10.21473/iknito-space/37886

Details

Type

Thesis

Created At

28 Jan 2023