Aortic Valve Periprosthetic Leakage: Anatomic Observations and Surgical Results Giuseppe De Cicco, MD, Roberto Lorusso, MD, PhD, Andrea Colli, MD, Francesco.

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Aortic Valve Periprosthetic Leakage: Anatomic Observations and Surgical Results Giuseppe De Cicco, MD, Roberto Lorusso, MD, PhD, Andrea Colli, MD, Francesco Nicolini, MD, Claudio Fragnito, MD, Teresa Grimaldi, MD, Bruno Borrello, MD, Alessandro Maria Budillon, MD, Tiziano Gherli, MD, Cesare Beghi, MD The Annals of Thoracic Surgery Volume 79, Issue 5, Pages 1480-1485 (May 2005) DOI: 10.1016/j.athoracsur.2004.11.058 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Partition of aortic annulus adopting a clock format. (LCS = left coronary sinus; NCS = noncoronary sinus; RCS = right coronary sinus.) The Annals of Thoracic Surgery 2005 79, 1480-1485DOI: (10.1016/j.athoracsur.2004.11.058) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Location and extent of periprosthetic leakage. Cases with leakage into the sector between hour 4 and hour 8 (n = 19). Cases with leakage into the sector between hour 8 and hour 4 (n = 20). (LCS = left coronary sinus; NCS = noncoronary sinus; RCS = right coronary sinus.) The Annals of Thoracic Surgery 2005 79, 1480-1485DOI: (10.1016/j.athoracsur.2004.11.058) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Relationship between the sector of periprosthetic leakage occurrence and the anatomy of the aortic annulus. (LCS = left coronary sinus; LVB = lateral aspect of left ventricular base; Me-Mu = muscular-membranous part of septum; Mu = muscular part of septum; MVAL = mitral valve anterior leaflet; NCS = noncoronary sinus; RCS = right coronary sinus.) (Modified from Sud A, et al, Ann Thorac Surg; 1984;38:76–9 [9], with permission.) The Annals of Thoracic Surgery 2005 79, 1480-1485DOI: (10.1016/j.athoracsur.2004.11.058) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Overall actuarial survival, including operative deaths. The Annals of Thoracic Surgery 2005 79, 1480-1485DOI: (10.1016/j.athoracsur.2004.11.058) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Adjusted Kaplan-Meier survival in patients (excluding operative deaths). (A) Periprosthetic leakage repair and prostheses replacement. (B) Mechanical prostheses and bioprostheses replacement. (pz = patients.) The Annals of Thoracic Surgery 2005 79, 1480-1485DOI: (10.1016/j.athoracsur.2004.11.058) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions