scholarly journals J-Shaped Upper Mini-Sternotomy Versus Full Sternotomy for Aortic Valve Replacement: A Comparative Study

2020 ◽  
Vol 23 (4) ◽  
pp. E411-E415
Author(s):  
Álvaro Borrero ◽  
Tatiana Julieth Samboni ◽  
Natalia Prado ◽  
Diana Cristina Carrillo-Gómez ◽  
German Camilo Giraldo-Gonzalez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Stay ◽  
Medical History ◽  
Valve Replacement ◽  
Clinical Care ◽  
Aortic Surgery ◽  
Lower Percentage ◽  
Intensive Care Stay

Background: This study aims to compare the characteristics between patients who underwent aortic valve replacement (AVR) through a J-shaped upper mini-sternotomy (UMS) and patients who underwent full sternotomy (FS) in the basis of clinical care and hospital outcomes. Methods: A retrospective, cross-sectional study was conducted on adult patients who were subjected to AVR by UMS from 2014 to 2017, compared with a historical control of patients who had undergone UMS by FS from 2011 to 2014. Patients, who received combined valve replacement or aortic surgery, as well as heart valve reinterventions due to endocarditis, were excluded. Sociodemographic characteristics, medical history, hospital and intensive care stay, blood transfusions, complications, and mortality of both procedures were compared. Results: There were 57 patients under UMS and 99 patients under FS included in this study. The median age was 67 years, and 56.77% of the patients were male. No differences were observed in the past medical history and the type of valve implanted between the groups. During surgery, patients under UMS received a lower percentage of red blood cell and platelet transfusions compared with FS. However, UMS had a higher percentage of cryoprecipitate transfusion. Intensive care stay was shorter in UMS compared with FS (three days; interquartile range [IQR], 2–4; and four days; IQR, 2–6, respectively) without differences in overall hospital stay, postoperative complications, in-hospital mortality, and 30-day mortality. Conclusions: The J-shaped upper mini-sternotomy is a feasible surgical technique that does not increase in-hospital or 30-day mortality, neither hospital stay nor infectious complications.

Minimally invasive aortic valve replacement reduces atelectasis in cardiac intensive care

2009 ◽  
Vol 11 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Signe Foghsgaard ◽  
Dunia Gazi ◽  
Karen Bach ◽  
Hanne Hansen ◽  
Thomas Andersen Schmidt ◽  
...  
Keyword(s):  
Intensive Care ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Cardiac Intensive Care

Abstract TP321: Performance of R 2 Cha 2 Ds 2 Vasc, Cha 2 Ds 2 Vasc, R 2 Chads 2 , and Chads 2 Scores for Predicting Stroke One Year After Transcatheter Aortic Valve Replacement

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Paul M Ndunda ◽  
Peter Tadros ◽  
Mark Wiley ◽  
Greg Muehlebach ◽  
George Zorn ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Clinical Care ◽  
Characteristic Curve ◽  
Discriminative Ability ◽  
Transcatheter Aortic Valve ◽  
Academic Center ◽  
One Year

Introduction: Stroke after transcatheter aortic valve replacement (TAVR) is a significant cause of morbidity and mortality. It increases the risk of mortality threefold, within one year of TAVR. It is also associated with significant disability and increased health care costs. A validated risk prediction tool for stroke one year after TAVR may be useful in risk stratification to guide decisions at the point of clinical care and in research. The objective of this study was to assess the calibration and discriminative ability of the R 2 CHA 2 DS 2 VASc, CHA 2 DS 2 VASc, R 2 CHADS 2 , and CHADS 2 scores for predicting stroke within one year of TAVR. Methods: This was a retrospective cohort study using data from a midwestern academic center TAVR program. Patients who underwent TAVR from 2012 to the first quarter of 2018 who had one-year follow-up data were included in the study. The model discrimination and calibration were assessed using the area under the receiver operating characteristic curve (c-statistic) and the Hosmer-Lemeshow test respectively. Results: Six hundred and sixty four patients met the inclusion criteria and 3.4% had stroke within one year of undergoing TAVR. They had a median age of 81 years and a mean STS score of 6.3. The R 2 CHA 2 DS 2 VASc, CHA 2 DS 2 VASc, R 2 CHADS 2 , and CHADS 2 scores had c-statistics of 0.591, 0.596, 0.607, and 0.622, respectively. The Hosmer-Lemeshow χ 2 p-values were 0.762, 0.422, 0.463 and 0.146 respectively. Conclusion: The CHADS 2 score had the best discriminative ability for stroke prediction one year after TAVR. All the four scores were well calibrated.

scholarly journals Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature

2020 ◽  
Vol 7 (3) ◽  
pp. 36
Author(s):  
Azka Latif ◽  
Noman Lateef ◽  
Muhammad Junaid Ahsan ◽  
Vikas Kapoor ◽  
Rana Mohammad Usman ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Stay ◽  
Valve Replacement ◽  
Lower Incidence ◽  
Surgical Aortic Valve Replacement ◽  
Clinical Endpoints ◽  
Duration Of Hospital Stay ◽  
All Cause Mortality

The number of patients with severe aortic stenosis (AS) and a history of prior cardiac surgery has increased. Prior cardiac surgery increases the risk of adverse outcomes in patients undergoing aortic valve replacement. To evaluate the impact of prior cardiac surgery on clinical endpoints in patients undergoing transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR), we performed a literature search using PubMed, Embase, Google Scholar, and Scopus databases. The clinical endpoints included in our study were 30-day mortality, 1–2-year mortality, acute kidney injury (AKI), bleeding, stroke, procedural time, and duration of hospital stay. Seven studies, which included a total of 8221 patients, were selected. Our study found that TAVR was associated with a lower incidence of stroke and bleeding complications. There was no significant difference in terms of AKI, 30-day all-cause mortality, and 1–2-year all-cause mortality between the two groups. The average procedure time and duration of hospital stay were 170 min less (p ≤ 0.01) and 3.6 days shorter (p < 0.01) in patients with TAVR, respectively. In patients with prior coronary artery bypass graft and severe AS, both TAVR and SAVR are reasonable options. However, TAVR may be associated with a lower incidence of complications like stroke and perioperative bleeding, in addition to a shorter length of stay.

scholarly journals Giant Aortic Pseudoaneurysm with Stanford Type A Aortic Dissection after Aortic Valve Replacement

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mertay Boran ◽  
Ali İhsan Parlar ◽  
Ertay Boran
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Type A Aortic Dissection ◽  
Aortic Pseudoaneurysm

Giant pseudoaneurysm of the ascending aorta is a rare but dreadful complication occurring several months or years after aortic surgery. Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture. We present a rare case of giant ascending aneurysm with Stanford type A aortic dissection occurring 6 years after aortic valve replacement and also illustrate the potential dimensions the ascending aorta may reach by a pseudoaneurysm and dissection after AVR.

scholarly journals Prospects of development in aortic surgery: literature review

2021 ◽  
Vol 37 (5) ◽  
pp. 43-51
Author(s):  
B. K. Kadyraliev ◽  
V. B. Arutyunyan ◽  
M. N. Askadinov ◽  
S. V. Kucherenko
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Malignant Tumors ◽  
Chronic Renal Disease ◽  
Aortic Surgery ◽  
Aortic Ring ◽  
Good Alternative ◽  
Aortic Dilatation ◽  
Repeated Surgery

Foreign sources of literature regarding the issue of aortic surgery are analyzed. Special attention is paid to aortic valve replacement using the Ozaki technique. The first replacement of aortic valve cusps with synthetic material was implemented by H. Th. Bahnson in 1959; he implanted the neocusp from Teflon. Nowadays, so as to replace the aortic valve, mechanical, biological valves, homotransplants, autotransplants and valves imitated endovascularly are actively applied. All the above mentioned types of the valves have both merits and demerits, therefore each patient should have an individual approach. When choosing the prosthesis and type of surgical intervention, cardiosurgeons take into account the following factors: patients age, availability of concomitant diseases (atrial fibrillation, chronic renal disease, malignant tumors), presence of small aortic ring, aortic dilatation, availability of other valve diseases, infectious endocarditis, first or repeated surgery on the valve as well as pregnancy or planning of pregnancy. In 2007, Shigeyuki Ozaki proposed the technique for replacement of all aortic valve cusps from autopericardium treated with 0.6 % glutaraldehyde solution. This surgery permits to form the aortic valve with excellent hemodynamic characteristics and low rate of reoperation in the early and remote periods. Aortic valve replacement using Ozaki technique is a perspective technique and good alternative for surgical treatment of aortic valve along with prostheses.

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