Asunto(s)
Implantación de Prótesis Vascular , Humanos , Implantación de Prótesis Vascular/métodos , Implantación de Prótesis Vascular/instrumentación , Implantación de Prótesis Vascular/efectos adversos , Seno Aórtico/cirugía , Seno Aórtico/diagnóstico por imagen , Resultado del Tratamiento , Prótesis Vascular , MasculinoAsunto(s)
Insuficiencia de la Válvula Aórtica , Síndrome de Marfan , Humanos , Síndrome de Marfan/complicaciones , Síndrome de Marfan/diagnóstico , Síndrome de Marfan/cirugía , Insuficiencia de la Válvula Aórtica/cirugía , Resultado del Tratamiento , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Estudios RetrospectivosAsunto(s)
Insuficiencia de la Válvula Aórtica , Estenosis de la Válvula Aórtica , Insuficiencia de la Válvula Mitral , Humanos , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/cirugía , Insuficiencia de la Válvula Mitral/cirugía , Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugíaRESUMEN
The internal geometric ring provides full three-dimensional annular stability while minimizing the dissection of the aortic root, pulmonary artery and right ventricle and avoids reimplanting the coronaries. The external annuloplasty provides a secondary stabilization of the easily accessed fibrous portion of the annulus using the sutures for the internal annuloplasty device and minimizes the sutures above the leaflets. Together they form a complete remodelling of the ventriculo-aortic junction following its exact course. The junction together with stabilization of the subcommissural triangles defines functional aortic annulus remodelling. External annuloplasty supports the virtual basal ring.
Asunto(s)
Insuficiencia de la Válvula Aórtica , Enfermedad de la Válvula Aórtica Bicúspide , Anuloplastia de la Válvula Cardíaca , Humanos , Insuficiencia de la Válvula Aórtica/cirugía , Resultado del Tratamiento , Anuloplastia de la Válvula Cardíaca/métodos , Válvula Aórtica/cirugíaAsunto(s)
Insuficiencia de la Válvula Aórtica , Enfermedad de la Válvula Aórtica Bicúspide , Procedimientos Quirúrgicos Cardíacos , Humanos , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVES: This study presents the results of 17 years of experience with bicuspid aortic valve (BAV) repair and the analysis of factors associated with repair failure and early echocardiographic outcome. METHODS: Between 2003 and 2020, a total of 206 patients [mean age: 44.5 ± 15.2 years; 152 males (74%)] with BAV insufficiency with or without aortic dilatation underwent elective aortic valve repair performed by a single surgeon with a mean follow-up of 5 ± 3.5 years. The transthoracic echocardiography examinations were reported. RESULTS: There were no deaths during the hospital stay, and all but 1 patient survived the follow-up period (99.5%). Overall, 10 patients (5%) developed severe insufficiency and 2 (1%) developed aortic dilatation requiring reoperation. Freedom from reoperation at 7 years reached 91.8%. Type 2 BAV configuration [hazard ratio (HR) 3.9; 95% confidence interval (CI): 1.01-60; P = 0.049], no sinotubular junction remodelling (HR 7; 95% CI: 1.7-23; P = 0.005), no circumferential annuloplasty (HR 3.9; 95% CI: 1.01-64; P = 0.047) and leaflet resection (HR 5.7; 95% CI 1.2-13. P = 0.017) have been identified as a risk factor of redo operation. Parameters of the postoperative left ventricle reverse remodelling improved significantly early after the operation and later at 2 years evaluation. CONCLUSIONS: The repair of BAV offers good short- and mid-term results providing a significant reverse left ventricular remodelling. Type 0 BAV preoperative configuration, circumferential annuloplasty and sinotubular junction remodelling are associated with better repair durability.