Aortic root enlargement: When and how

2020 ◽  
Vol 36 (1) ◽  
pp. 229-235
Author(s):  
Samuel A. Massias ◽  
Ashleigh Pittams ◽  
Malak Mohamed ◽  
Shajada Ahmed ◽  
Hiba Younas ◽  
...  
Keyword(s):  
Aortic Root ◽  
Aortic Root Enlargement

Functional Results in Aortic Root Enlargement

2004 ◽  
Vol 7 (2) ◽  
pp. E160-E163 ◽  
Author(s):  
Serap Aykut Aka ◽  
Gökçen Orhan ◽  
Şennur Ünal ◽  
Seden Çelik ◽  
Şahin Şenay ◽  
...  
Keyword(s):  
Aortic Root ◽  
Functional Results ◽  
Aortic Root Enlargement

Racial and ethnic differences in response to treatment for Marfan syndrome

2021 ◽  
pp. 1-8
Author(s):  
Rachel Ayers ◽  
Michael Kelleman ◽  
Glen Iannucci ◽  
Courtney McCracken ◽  
Matthew E. Oster
Keyword(s):  
Marfan Syndrome ◽  
Ethnic Differences ◽  
Aortic Root ◽  
Randomised Trial ◽  
Z Score ◽  
Treatment Groups ◽  
Black Patients ◽  
Aortic Root Enlargement ◽  
Racial Ethnic ◽  
Hispanic White

Abstract Objective: To determine whether racial/ethnic differences exist for the treatment of Marfan syndrome aortopathy. The 2014 Pediatric Heart Network randomised trial of losartan versus atenolol in Marfan syndrome paediatric and young adult patients showed no treatment differences in the rate of aortic root growth over 3 years; however, they did not examine racial/ethnic differences, and recent data suggest that angiotensin receptor blockers may have different pharmacologic effects in different racial/ethnic populations. Methods: We performed a secondary analysis of public-use data from the Pediatric Heart Network randomised trial comparing the differences by race/ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic patients) amongst the treatment groups for the primary outcome of rate of aortic root enlargement by z score and secondary outcome of rate of change of absolute diameter of aortic root, z score and absolute diameter of ascending aorta, and blood pressure changes. Results: For aortic root enlargement by z score amongst on-Hispanic White patients, patients on losartan exhibited an annual z score change of –0.090 ± 0.016, compared to –0.146 ± 0.015 for those on atenolol (p = 0.01), favouring atenolol. For Hispanic and non-Hispanic Black patients, there was no difference in primary or secondary outcomes between treatment groups. Conclusion: Non-Hispanic White patients had a small, but statistically significantly greater decrease in aortic root z score favouring atenolol over losartan. There were no significant differences amongst Hispanic or non-Hispanic Black patients, which may be due to relatively small size numbers. These findings may have important implications for medication selection by race/ethnicity in Marfan syndrome patients, which has not previously been evaluated in studies.

Fate of Bicuspid Aortic Valves in Patients Undergoing Aortic Root Repair or Replacement for Aortic Root Enlargement

2006 ◽  
Vol 81 (3) ◽  
pp. 322-326 ◽  
Author(s):  
Gruschen R. Veldtman ◽  
Heidi M. Connolly ◽  
Thomas A. Orszulak ◽  
Joseph A. Dearani ◽  
Hartzell V. Schaff
Keyword(s):  
Aortic Root ◽  
Aortic Valves ◽  
Root Repair ◽  
Bicuspid Aortic Valves ◽  
Aortic Root Enlargement ◽  
Aortic Root Repair

scholarly journals Tanned xenograft pericardium for aortic root enlargement during aortic valve replacement

1991 ◽  
Vol 17 (2) ◽  
pp. A361
Author(s):  
Donato Sisto ◽  
Sylvia Fernandes ◽  
Antonio Palma ◽  
Michele Nanna ◽  
Robert Frater
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Aortic Root Enlargement

Abstract 18662: Aortic Valve Orientation Angle is Associated With Aortic Morphology and Dissection Risk

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ashutosh A Hardikar ◽  
Andrea Iannaccone ◽  
Thomas H Marwick
Keyword(s):  
Aortic Root ◽  
Orientation Angle ◽  
Aortic Disease ◽  
Asymmetry Index ◽  
Aortic Annulus ◽  
Shear Stresses ◽  
Aortic Dilatation ◽  
Left Wall ◽  
Root Angle ◽  
Aortic Root Enlargement

Introduction: Asymmetric aortic root enlargement may lead to unequal thinning of the aortic wall, differential shear stresses and dissection. We sought the association of aortic root morphology with aortoventricular angle (AVAng), LVOT-root angle (RootAng), root-aorta angle (AortAng) [Fig 1] and outcomes. Methods: Demographic, morphometric and epidemiological parameters were gathered in 100 patients with aortic disease over last 6 years and 50 age and sex matched controls undergoing aortic CT. Two observers measured AVAng, RootAng, AortAng between the proximal aorta, aortic annulus and LV outflow tract [Figure 1] and orthogonal diameters along the thoracic aorta, noting the type of arch and other pathologies. The root axis was taken by joining the midpoints of aortic annulus and sinotubular junction, and asymmetry index (AI) [Fig 1] was calculated as the ratio of the maximal distance between axis and right wall, and axis to left wall in coronal view. There were 22 aortic dissections in the study group, and follow up was 32.3 months. Results: AortAng was different between TAV and BAV, but AI and AVAng were similar. AortAng [P= 0.008], AI [P= 0.004] and AVAng [p=0.013] had the strongest correlation with aortic dilatation [>40 mm], and were different in the dissection group (Table). The AI correlated well with root dilatation while AortAng and AVAng correlated with ascending aortic dilatation. TAV had a diffuse pattern of aortic dilatation as compared to BAV. Conclusions: AVAng and RootAng correlate with aortic dilatation patterns, and also aortic dissection. The AVAng and AortAng may explain the differential shear stresses seen along the 2 curvatures in aortic pathologies.

scholarly journals Aortic Root Enlargement In Case of Double Valve Replacement

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 108-110 ◽  
Author(s):  
Mahbub Ahsan ◽  
Md Lutfar Rahman ◽  
ASM Shariful Islam ◽  
Mohammad Arifur Rahman
Keyword(s):  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Survival Rate ◽  
Valve Replacement ◽  
Aortic Root ◽  
Double Valve Replacement ◽  
Post Operative Period ◽  
Patient Prosthesis Mismatch ◽  
Small Aortic Root ◽  
Aortic Root Enlargement

Rheumatic valvular heart disease is quite common in Bangladesh. It affects most commonly mitral and aortic valve. As a result of annular fibrosis, aortic root become smaller in some patients. So, if smaller prosthesis is implanted, there is gross patient prosthesis mismatch (PPM), poor LV regression, increase overload, and ultimately low survival rate. Its' to report our experience in aortic root enlargement in case of double valve replacement where a patient of severe mitral stenosis and aortic regurgitation with small aortic annulus requiring aortic root enlargement (ARE).Weaning from Cardiopulmonary bypass (CPB) was uneventful, perioperative and post operative period was satisfactory. Post-operative echocardiography revealed normally functioning prosthesis. In case of small aortic root, aortic root enlargement (ARE) can be safely done by double valve replacement to overcome the prosthetic patient mismatch (PPM). KYAMC Journal Vol. 11, No.-2, July 2020, Page 108-110

Aortic Root Enlargement in Octogenarian Patients Results in Less Patient Prosthesis Mismatch

2014 ◽  
Vol 97 (5) ◽  
pp. 1533-1538 ◽  
Author(s):  
Juan G. Penaranda ◽  
Kevin L. Greason ◽  
Sorin V. Pislaru ◽  
Hartzell V. Schaff ◽  
Richard C. Daly ◽  
...  
Keyword(s):  
Aortic Root ◽  
Patient Prosthesis Mismatch ◽  
Aortic Root Enlargement
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