Relationship between the membranous septum and the virtual basal ring of the aortic root in candidates for transcatheter implantation of the aortic valve

2018 ◽  
Vol 31 (4) ◽  
pp. 525-534 ◽  
Author(s):  
Shumpei Mori ◽  
Justin T. Tretter ◽  
Takayoshi Toba ◽  
Yu Izawa ◽  
Natsuko Tahara ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Basal Ring ◽  
Transcatheter Implantation ◽  
Membranous Septum

scholarly journals Anatomical predictors of conduction damage after transcatheter implantation of the aortic valve

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000972 ◽  
Author(s):  
Justin T Tretter ◽  
Shumpei Mori ◽  
Robert H Anderson ◽  
Michael D Taylor ◽  
Nicholas Ollberding ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Anatomical Variation ◽  
Radial Force ◽  
Adverse Outcomes ◽  
Bundle Branch Block ◽  
Inferior Margin ◽  
Transcatheter Aortic Valve ◽  
The Impact ◽  
Membranous Septum

ObjectiveConduction damage following transcatheter aortic valve implantation (TAVI) remains common. Anatomical risk factors remain elusive. We assessed the impact of variability in the dimensions of the membranous septum and position of the aortic root on the occurrence of conduction damage following TAVI.MethodsThe dimensions of the membranous septum, the rotational position of the aortic root correlating to variability in the central fibrous body width, and wedging of the aortic root were assessed on pre-TAVI CT datasets. The depth of implantation was measured from the final aortic angiogram. The variables were compared with the occurrence of both permanent pacemaker insertion (PPI) and left bundle branch block (LBBB) following TAVI.ResultsOf 200 patients who met inclusion criteria (mean age = 81 years ± 7.7, 49% men), 20.5 % underwent PPI after TAVI. New LBBB occurred in 23.5%, 21.3 % of whom required PPI. Preprocedural right bundle branch block (OR = 7.00; CI 3.13 to 15.64), valve type (OR=2.35; CI 1.13 to 4.87), depth of implantation (OR=1.62; CI 1.01 to 2.61) and the difference between depth of implantation and the distance from the virtual basal ring to the inferior margin of the membranous septum (OR=0.61; CI 0.38 to 0.99) were all associated with PPI, with similar associations with LBBB. No gross anatomical variable alone was associated with conduction damage.ConclusionsGross anatomical variation of the aortic root and its underlying support, including the membranous septum, were not associated with the occurrence of either PPI or new LBBB. Procedural characteristics associated with these adverse outcomes suggest that the depth of implantation and radial force of the bioprosthesis, regardless of gross anatomical variability, increase the risk for conduction damage.

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Allograft replacement of the aortic root for acute extensive aortic valve endocarditis

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
A El-Essawi ◽  
M Anssar ◽  
I Kutschka ◽  
S Ulrich ◽  
I Falkuss ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root

Emergency aortic root replacement with the Bioconduit stentless aortic valve conduit

2020 ◽  
Vol 25 (6) ◽  
pp. 2055-2059
Author(s):  
ADRIAN TULIN ◽  
◽  
OVIDIU STIRU ◽  
MIRUNA LUANA MIULESCU ◽  
LAURA RADUCU ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Root ◽  
Aortic Root Replacement ◽  
Bentall Operation ◽  
Severe Aortic Regurgitation ◽  
Valve Conduit ◽  
Successful Case ◽  
Valved Conduit

This report concerns a 73-year-old woman who presented with asymptomatic aortic root an-eurysm with severe aortic regurgitation. The purpose of this article is to present our first successful case for emergency aortic root replacement (Bentall operation) that involves annular implantation of a pericardial valved conduit (Bioconduit TM, Biointegral Surgical, Inc., Ontario, Canada) and to discuss some essential technical clue issues related to this approach.

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