Long-Term Durability of Bicuspid Aortic Valve Repair

Slides:

Advertisements

Similar presentations

Long-term Survival, Valve Durability, and Reoperation for Four Aortic Root + Ascending Procedures Lars G. Svensson, Saila T. Pillai, Jeevanantham Rajeswaran,

Advertisements

Tomislav Mihaljevic, MD, Edward R

Moderate Tricuspid Regurgitation With Left-Sided Degenerative Heart Valve Disease: To Repair or Not to Repair? Jose L. Navia, MD, Nicolas A. Brozzi,

Results of Coronary Artery Endarterectomy and Coronary Artery Bypass Grafting for Diffuse Coronary Artery Disease Srikrishna Sirivella, MD, Isaac Gielchinsky,

Spinal cord protective strategies during descending and thoracoabdominal aortic aneurysm repair in the modern era: The role of intrathecal papaverine

Characterization and Importance of Air Leak After Lobectomy

A. Marc Gillinov, MD, Tomislav Mihaljevic, MD, Eugene H

Longitudinal Outcome of Isolated Mitral Repair in Older Patients: Results From 14,604 Procedures Performed From 1991 to 2007 Vinay Badhwar, MD, Eric.

Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis Syed T. Hussain, MD, Nabin K. Shrestha, MD, Steven.

Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? Jose L. Navia, MD, Edward R. Nowicki, MD,

Moderate Tricuspid Regurgitation With Left-Sided Degenerative Heart Valve Disease: To Repair or Not to Repair? Jose L. Navia, MD, Nicolas A. Brozzi,

Advising complex patients who require complex heart operations

Lars G. Svensson, MD, PhD, Lillian H. Batizy, MS, Eugene H

Morbidity of Bleeding After Cardiac Surgery: Is It Blood Transfusion, Reoperation for Bleeding, or Both? Alessandro Vivacqua, MD, Colleen G. Koch, MD,

Hancock II Bioprosthesis for Aortic Valve Replacement: The Gold Standard of Bioprosthetic Valves Durability? Tirone E. David, MD, Susan Armstrong, MS,

Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: A propensity score analysis Christophe de Meester, MS, Agnès Pasquet,

Current Effectiveness and Risks of Isolated Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy Nicholas G. Smedira, MD, Bruce W. Lytle, MD,

Beyond the Aortic Root: Staged Open and Endovascular Repair of Arch and Descending Aorta in Patients With Connective Tissue Disorders Eric E. Roselli,

Endovascular versus open elephant trunk completion for extensive aortic disease Eric E. Roselli, MD, Sreekumar Subramanian, MD, Zhiyuan Sun, BS, Jahanzaib.

Mitral Valve Surgery in the Adult Marfan Syndrome Patient

Valve Replacement for Severe Aortic Stenosis With Low Transvalvular Gradient and Left Ventricular Ejection Fraction Exceeding 0.50 Giuseppe Tarantini,

Long-Term Consequences of Postoperative Heart Failure After Surgery for Aortic Stenosis Compared With Coronary Surgery Farkas B. Vánky, MD, PhD, Erik.

Surgical treatment of pseudoaneurysm of the thoracic aorta

Surgical Treatment of Postinfarction Left Ventricular Pseudoaneurysm

Eleven-Year Single-Center Experience with the ATS Open Pivot Bileaflet Heart Valve Doan Baykut, MD, Leticia Grize, PhD, Christian Schindler, PhD, Angelika.

Michael E. Halkos, MD, Patrick Kilgo, MS, Omar M

Reoperation After Mitral Valve Repair for Degenerative Disease

Bruce W. Lytle, MD, Eugene H. Blackstone, MD, Joseph F

Surgical revascularization techniques that minimize surgical risk and maximize late survival after coronary artery bypass grafting in patients with diabetes.

Coronary artery bypass grafting in diabetics: A growing health care cost crisis Sajjad Raza, MD, Joseph F. Sabik, MD, Ponnuthurai Ainkaran, MS, Eugene.

Chronic Atrial Fibrillation Is Associated With Reduced Survival After Aortic and Double Valve Replacement Richard Schulenberg, MD, Polychronis Antonitsis,

Surgical Repair of Posterior Mitral Valve Prolapse: Implications for Guidelines and Percutaneous Repair Douglas R. Johnston, MD, A. Marc Gillinov, MD,

Long-Term Follow-Up After Thoracoabdominal Aortic Aneurysm Repair

A. Marc Gillinov, MD, Sekar Bhavani, MD, Eugene H

Options for repair of a bicuspid aortic valve and ascending aortic aneurysm Thoralf M Sundt, MD, Bassem N Mora, MD, Marc R Moon, MD, Marci S Bailey, MSN,

Charles M. Wojnarski, MD, Lars G. Svensson, MD, PhD, Eric E

Spinal cord protective strategies during descending and thoracoabdominal aortic aneurysm repair in the modern era: The role of intrathecal papaverine

Does a similar procedure result in similar survival for women and men undergoing isolated coronary artery bypass grafting? Tamer Attia, MD, MSc, Colleen.

Simple versus complex degenerative mitral valve disease

A. Marc Gillinov, MD, Eugene H. Blackstone, MD, Edward R

Ahmad Zeeshan, MD, Jay J. Idrees, MD, Douglas R

Tricuspid Regurgitation Associated With Ischemic Mitral Regurgitation: Characterization, Evolution After Mitral Surgery, and Value of Tricuspid Repair

Reduced survival in women after valve surgery for aortic regurgitationEffect of aortic enlargement and late aortic rupture Monica L. McDonald, MDa, Nicholas.

Farhang Yazdchi, MD, MS, Colleen G

Vinod H. Thourani, MD, Hanna A

Outcomes of less invasive J-incision approach to aortic valve surgery

Aortic Valve Replacement and Concomitant Coronary Artery Bypass: Assessing the Impact of Multiple Grafts Kimiyoshi J. Kobayashi, BS, Jason A. Williams,

Lars G. Svensson, MD, PhD, Gregory D

Distal aortic interventions after repair of ascending dissection: The argument for a more aggressive approach Eric E. Roselli, MD, Gabriel Loor, MD,

Edward R. Nowicki, MD, MS, Gösta B. Pettersson, MD, PhD, Nicholas G

Outcomes of a Less-Invasive Approach for Proximal Aortic Operations

Twenty-Year Experience With the CarboMedics Mechanical Valve Prosthesis Denis Bouchard, MD, Amine Mazine, MD, Louis-Mathieu Stevens, MD, Michel Pellerin,

Aortic Valve Replacement for Patients With Severe Aortic Stenosis: Risk Factors and Their Impact on 30-Month Mortality Edward L. Hannan, PhD, Zaza Samadashvili,

Long-term effectiveness of operations for ascending aortic dissections

Postoperative Outcome of Isolated Tricuspid Valve Operation Using Arrested-Heart or Beating-Heart Technique Bettina Pfannmüller, MD, Piroze Davierwala,

Mitral Valve Abnormalities in Hypertrophic Cardiomyopathy: Echocardiographic Features and Surgical Outcomes Ryan K. Kaple, BS, Ross T. Murphy, MD, Linda.

Lars G. Svensson, MD, PhD, Fernando A. Atik, MD, Delos M

Truncus Arteriosus Associated with Interrupted Aortic Arch in 50 Neonates: A Congenital Heart Surgeons Society Study Igor E. Konstantinov, MD, PhD, Tara.

Mohammed A Quader, MD, Patrick M McCarthy, MD, A

Joseph F. Sabik, MD, Gabriel Olivares, MD, Sajjad Raza, MD, Bruce W

Douglas R. Johnston, MD, Edward G

Endocarditis after mitral valve repair

Turki B. Albacker, MD, MSc, Eugene H. Blackstone, MD, Sarah J

United States Feasibility Study of Transcatheter Insertion of a Stented Aortic Valve by the Left Ventricular Apex Lars G. Svensson, MD, PhD, Todd Dewey,

Age and valve size effect on the long-term durability of the Carpentier-Edwards aortic pericardial bioprosthesis Michael K Banbury, MD, Delos M Cosgrove,

Mitral valve repair with aortic valve replacement is superior to double valve replacement A.Marc Gillinov, MD, Eugene H Blackstone, MD, Delos M Cosgrove,

Pulmonary hypertension is associated with worse early and late outcomes after aortic valve replacement: Implications for transcatheter aortic valve replacement

Mitral Repair Versus Replacement for Ischemic Mitral Regurgitation

Wilson Y. Szeto, MD, Joseph E. Bavaria, MD, Frank W

Umar S. Boston, MD, Joseph A. Dearani, MD, Patrick W

Presentation transcript:

Long-Term Durability of Bicuspid Aortic Valve Repair Lars G. Svensson, MD, PhD, Adil H. Al Kindi, MD, Alessandro Vivacqua, MD, Gösta B. Pettersson, MD, PhD, A. Marc Gillinov, MD, Tomislav Mihaljevic, MD, Eric E. Roselli, MD, Joseph F. Sabik, MD, Brian Griffin, MD, Donald F. Hammer, MD, Leonardo Rodriguez, MD, Sarah J. Williams, MS, Eugene H. Blackstone, MD, Bruce W. Lytle, MD The Annals of Thoracic Surgery Volume 97, Issue 5, Pages 1539-1548 (May 2014) DOI: 10.1016/j.athoracsur.2013.11.036 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Surgical technique for repair of bicuspid aortic valve. (A) Repair sutures for most repairs. (B) Mobilization of commissures for a large root. (C) Closure of gaps in aortic root. (D) Reattachment of commissures resuspended at a higher level in ascending aorta tube graft. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Freedom from aortic valve reoperation after repair of bicuspid aortic valve. Each symbol (○) represents a reoperation positioned nonparametrically, vertical bars are confidence limits equivalent to ±1 standard error, and numbers in parentheses are patients still alive. Solid line is parametric estimate enclosed within dashed 68% confidence band equivalent to ±1 standard error. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Reasons for reoperation and the reoperative procedures performed. (AR = aortic regurgitation; AS = aortic stenosis; AVR = aortic valve replacement; CABG = coronary artery bypass grafting; MVR = mitral valve replacement.) The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Aortic valve regurgitation (AR) across time after aortic valve repair. Circles represent grouped data without regard to repeated measurements. Solid lines are model-based estimates that account for repeated measurements. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Aortic valve (AV) gradient after repair of bicuspid aortic valve disease. Circles represent grouped data without regard to repeated measurements. Solid lines are model-based estimates. Preoperative (Preop) values shown as a bold dot. (A) Mean gradient. (B) Peak gradient. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Left ventricular (LV) mass index after aortic valve repair for bicuspid disease. Circles represent grouped data without regard to repeated measurements. Solid line is model-based estimate. Late increase in LV mass index is about 0.85 g/m2 per year. Preoperative (Preop) value shown as a bold dot. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Survival after aortic valve repair for bicuspid aortic valve disease. Each symbol (○) represents a death positioned nonparametrically, vertical bars are confidence limits equivalent to ±1 standard error, and numbers in parentheses are patients still alive. Solid line is parametric estimate enclosed within dashed 68% confidence band equivalent to ±1 standard error. Dash-dot-dash line represents survival of an age-sex-race–matched US population life table. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 Survival stratified by New York Heart Association (NYHA) functional class. Each symbol represents a death positioned on a vertical axis by the Kaplan-Meier estimator, vertical bars are 68% confidence limits equivalent to ±1 standard error, and numbers in parentheses are number of patients still alive and being traced. The Annals of Thoracic Surgery 2014 97, 1539-1548DOI: (10.1016/j.athoracsur.2013.11.036) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions