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AORTIC REGURGITATION WITH AND WITHOUT ASCENDING AORTIC ANEURYSM: VALVE REPAIR TECHNIQUES MARKO TURINA University Hospital Zurich, Switzerland.

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Presentation on theme: "AORTIC REGURGITATION WITH AND WITHOUT ASCENDING AORTIC ANEURYSM: VALVE REPAIR TECHNIQUES MARKO TURINA University Hospital Zurich, Switzerland."— Presentation transcript:

1 AORTIC REGURGITATION WITH AND WITHOUT ASCENDING AORTIC ANEURYSM: VALVE REPAIR TECHNIQUES MARKO TURINA University Hospital Zurich, Switzerland

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5 Two dimensional echocardiogram. Evangelista A Heart 2010;96:979-985 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.

6 Loss of commissural support due to dilatation of sino-tubular junction

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9 Repair-oriented functional classification of aortic insufficiency with a description of disease mechanisms and repair techniques employed. Boodhwani M et al. MMCTS 2009;2009:mmcts.2008.003806 © 2009 European Association for Cardio-thoracic Surgery

10 These diagrams demonstrate the static and basic functional anatomy of the aortic root valve complex. Hopkins R A Eur J Cardiothorac Surg 2003;24:886-897 © 2003 Elsevier B.V.

11 Tirone David I. the sequence demonstrates the surgical approach described initially by Tirone David in 1992, which is now known as the reimplantation technique (TD I). Hopkins R A Eur J Cardiothorac Surg 2003;24:886-897 © 2003 Elsevier B.V.

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13 Sarsam and Yacoub 1993 technique of remodeling. Hopkins R A Eur J Cardiothorac Surg 2003;24:886-897 © 2003 Elsevier B.V.

14 1995 Tirone David II Remodeling. Hopkins R A Eur J Cardiothorac Surg 2003;24:886-897 © 2003 Elsevier B.V.

15 1996 Tirone David III Remodeling. Hopkins R A Eur J Cardiothorac Surg 2003;24:886-897 © 2003 Elsevier B.V.

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17 DANGEROUS TECHNIQUE, TO BE AVOIDED

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21 Cusp shortening with 7-0 PTFE suture

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24 http://www.youtube.com/watch?v=JPH5nwnFgQk http://www.youtube.com/watch?v=eudbXsxIppE&feature=related http://mmcts.oxfordjournals.org/cgi/collection/aortic_valve_repair http://mmcts.oxfordjournals.org/content/2009/0702/mmcts.2008.0 03806.full Some instructive video clips and MMCTS contributions

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