Aortic Valve Reconstruction of Unicuspid Aortic Valve by Tricuspidization Using Autologous Pericardium Isamu Kawase, MD, Shigeyuki Ozaki, MD, PhD, Hiromasa.

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Presentation transcript:

Aortic Valve Reconstruction of Unicuspid Aortic Valve by Tricuspidization Using Autologous Pericardium Isamu Kawase, MD, Shigeyuki Ozaki, MD, PhD, Hiromasa Yamashita, MD, Shin Uchida, MD, Yukinari Nozawa, MD, Takayoshi Matsuyama, MD, Mikio Takatoh, MD, So Hagiwara, MD The Annals of Thoracic Surgery Volume 94, Issue 4, Pages 1180-1184 (October 2012) DOI: 10.1016/j.athoracsur.2012.05.016 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Excised aortic valve. Only 1 area of valve orifice opening reaches the annulus. The Annals of Thoracic Surgery 2012 94, 1180-1184DOI: (10.1016/j.athoracsur.2012.05.016) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Creation of new commissure. Newly created commissure is marked at a higher position—the same height of sole existing commissure along the raphe. The Annals of Thoracic Surgery 2012 94, 1180-1184DOI: (10.1016/j.athoracsur.2012.05.016) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Shape of pericardial leaflet on template. It is designed to have annular zone and coaptation zone with margin to seam. Its free-edge length is proportional to distance between each commissure. The Annals of Thoracic Surgery 2012 94, 1180-1184DOI: (10.1016/j.athoracsur.2012.05.016) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Completion of aortic valve reconstruction. Commissural height is equalized as the height of sole preexisting commissure. (LCC = left coronary cusp; NCC = non coronary cusp; RCC = right coronary cusp.) The Annals of Thoracic Surgery 2012 94, 1180-1184DOI: (10.1016/j.athoracsur.2012.05.016) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Difference of total free-edge length of tricuspid and unicuspid aortic valves. Total length of free edge of unicommissural unicuspid aortic valve (red line) is shorter than total length of free edge of tricuspid aortic valve (blue line). (LCS = left coronary sinus; NCS = non coronary sinus; RCS = right coronary sinus.) The Annals of Thoracic Surgery 2012 94, 1180-1184DOI: (10.1016/j.athoracsur.2012.05.016) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions