Root Remodeling and Aortic Valve Repair for Unicuspid Aortic Valve

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Presentation transcript:

Root Remodeling and Aortic Valve Repair for Unicuspid Aortic Valve Marco Franciulli, MD, Diana Aicher, MD, Tanja Rädle-Hurst, MD, Hiroaki Takahashi, MD, PhD, Svetlana Rodionycheva, MD, Hans- Joachim Schäfers, MD, PhD The Annals of Thoracic Surgery Volume 98, Issue 3, Pages 823-829 (September 2014) DOI: 10.1016/j.athoracsur.2014.05.024 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Drawing of the initial operative steps. The unicuspid valve is characterized by one normal and two rudimentary commissures. A tongue of aortic tissue is left adjacent to the normal commissure and opposite that commissure. The coronary ostia are mobilized (dashed lines). The Annals of Thoracic Surgery 2014 98, 823-829DOI: (10.1016/j.athoracsur.2014.05.024) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Drawing of the next operative steps. The hypoplastic right cusp including its commissural zones is resected. A Dacron graft is tailored to create two symmetric tongues that are then brought into the root and sutured to the remnants of aortic wall. The Annals of Thoracic Surgery 2014 98, 823-829DOI: (10.1016/j.athoracsur.2014.05.024) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Drawing of the completed procedure. Using pericardial patches, the two cusps have been reconstructed to create a symmetric bicuspid design with two commissures of normal height. The Annals of Thoracic Surgery 2014 98, 823-829DOI: (10.1016/j.athoracsur.2014.05.024) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Actuarial freedom from reoperation of patients after root remodeling and aortic valve repair for unicuspid aortic valve. The Annals of Thoracic Surgery 2014 98, 823-829DOI: (10.1016/j.athoracsur.2014.05.024) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Actuarial freedom from aortic valve replacement of patients after root remodeling and aortic valve repair for unicuspid aortic valve. The Annals of Thoracic Surgery 2014 98, 823-829DOI: (10.1016/j.athoracsur.2014.05.024) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions