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Cardiovascular operations for Loeys-Dietz syndrome: Intermediate-term results  Nishant D. Patel, MD, Todd Crawford, MD, J. Trent Magruder, MD, Diane E.

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Presentation on theme: "Cardiovascular operations for Loeys-Dietz syndrome: Intermediate-term results  Nishant D. Patel, MD, Todd Crawford, MD, J. Trent Magruder, MD, Diane E."— Presentation transcript:

1 Cardiovascular operations for Loeys-Dietz syndrome: Intermediate-term results 
Nishant D. Patel, MD, Todd Crawford, MD, J. Trent Magruder, MD, Diane E. Alejo, BA, Narutoshi Hibino, MD, James Black, MD, Harry C. Dietz, MD, Luca A. Vricella, MD, Duke E. Cameron, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 153, Issue 2, Pages (February 2017) DOI: /j.jtcvs Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Reimplantation valve-sparing root replacement.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Kaplan-Meier survival curve.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Freedom from reintervention.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

5 Reimplantation valve-sparing root replacement.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

6 Video 1 Valve-sparing aortic root replacement—surgical technique.
Please see Cameron DE. Valve-sparing aortic root replacement. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann. 2012;15:20-3. In brief, the operation is performed via median sternotomy using central aortic and bicaval venous cannulation, venting via the right superior pulmonary vein, moderate systemic hypothermia to 28°C, and blood cardioplegia. The right atrium is explored and a patent foramen ovale, if present, is closed in each case. The aorta is divided above the sinotubular junction and a graft that is 3 to 4 mm larger than the optimal sinotubular diameter that maximized leaflet apposition is chosen. The graft is trimmed, leaving 2 to 3 rings below the sinus segment and 4 to 5 rings above. Three pledgetted subannular mattress sutures are placed from within the left ventricular outflow tract outward and are used to secure the graft and ensure that the valve sits within the sinus of the graft. The commissures are fixed to the sinotubular junction of the graft with pledgetted mattress sutures. The annulus and sinus remnant are sewn to the inside of the graft with 4-0 or 5-0 polypropylene sutures. The coronary buttons are anastomosed to the sinus segments of the graft with external felt strip reinforcement. The valve is then inspected for prolapse, which can be addressed with leaflet plication or free edge suspension. Finally, the distal anastomosis is then performed with felt strip reinforcement. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

7 The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

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