Technique of Comprehensive Aortic Root and Valve Reconstruction for Aortic Valve and Root Disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 MAJin-feng , ZHANGYu , YOUChun-juan , CHENJia-hua , XIEZhi-qiang , CHENYuan-yuan

CARVAR Heart Center, the First People’s Hospital of Yinchuan, Yinchuan 750001,P.R.China;

Corresponding?author：

MAJin-feng, Email: wdbbl36@163.com

Keywords：

Comprehensive aortic root and valve reconstruction; Aorta; Valve and root disease

DOI：

10.7507/1007-4848.20160087

Video：

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Objective To analyze clinical outcome of the technique of comprehensive aortic root and valve reconstruction (CARVAR) applying in aortic valve and root disease. Methods We retrospectively analyzed the clinical data of 106 patients with aortic valve and root disease underwent CARVAR technique in our hospital from July 2012 to July 2015. There were 72 males and 34 females at the average age of 57.3 (11-67) years. We operated the CARVAR technique and analyzed the early and midterm clinical outcomes. Results There was no mortality and low cardiac output syndrome postoperatively. But there were 2 cases of renal insufficiency or failure and 1 case of infective endocarditis. The average ejection fraction was 54%. The mean area of aortic valve orifice was 2.2±0.8 cm². The aortic valve pressure gradient was 11.2±2.3 mm Hg. There were 2 cases of mild aortic valve regurgitation. The result of operation was satisfying with a stable hemodynamics and few complications. The follow-up after surgery showed that there was no obvious abnormity in aortic valve and root. Conclusion Using CARVAR technique to cure aortic valve and root disease is an effective treatment and it can achieve satisfactory early and midterm clinical outcomes.

Citation： MAJin-feng, ZHANGYu, YOUChun-juan, CHENJia-hua, XIEZhi-qiang, CHENYuan-yuan. Technique of Comprehensive Aortic Root and Valve Reconstruction for Aortic Valve and Root Disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 377-379. doi: 10.7507/1007-4848.20160087 Copy

1.	Hahm SY, Choo SJ, Lee JW, et al. Novel technique of aortic valvuloplasty. Eur J Cardiothorac Surg, 2006, 29(5): 530-536.
2.	魏宇淼, 廖玉華, 王國榮, 等. 主動脈瓣疾病類型及變遷分析. 武漢大學學報醫學版, 2009, 30(3): 107-110.
3.	Song MG. Aortic valve reconstruction with leaf replacement and sinotubular junction fixation early and midterm results. Soc Thorac Surg, 2014, 12(11): 154-156.
4.	Song MG. Song innovative aortic root and valve reconstruction. Korea Koonja Publishing, 2013, 11(2): 236-238.
5.	Tanigawa K, Eishi K, Yamachika S, et al. Comparison of the effects of aortic valve replacement using 19 mm Carpentier-Edwards Perimount bioprosthesis and 19 mm Medtronic Mosaic bioprosthesis. Ann Thorac Cardiovasc Surg, 2008, 14(8): 17.
6.	Bernal JM, Pontyn A, Diaz B, et al. Combined mitral and tricuspid valve repair in rheumatic valve disease: fewer reoperations with prosthetic ring annuloplasty. Circulation, 2010, 12(8): 1934-1940.
7.	Yoda M, Tanabe H, Kadoma Y, et al. Mid-term results of tricuspid annuloplasty using the MC3 ring for secondary tricuspid valve regurgitation. Interact Cardiovasc Thorac Surg, 2011, 13(1): 7-10.
8.	侯曉彤, 孟旭, 李偉, 等. 左心系統瓣膜替換術后遠期三尖瓣關閉不全的手術治療效果. 中華醫學雜志, 2005, 85(12): 3362-3364.
9.	MeCarthy P, Bhudia S, Rajeswaran J. Tricuspid valve repair: durability and risk factors for failure. Thorac Cardiovasc Surg, 2004, 12(7): 674-685.
10.	潘世偉, 胡盛壽, 許建屏, 等. 成形軟環應用于三尖瓣關閉不全修復的療效評價. 中國循環雜志, 2009, 24(3): 379-382.
11.	宋邦榮, 來永強, 崔永超, 等. 主動脈瓣置換術后室間隔厚度對主動脈瓣跨瓣壓差的影響. 中華胸心血管外科雜志, 2012, 28(5): 282-284.
12.	Pibarot P, Dumesnil JG, Lemieux M, et al. Impact of prosthesis patient mismatch on hemodynamic and symptomatic status, mot-bidity, and mortality after aortic valve replacement with a bioprostheticheart valve. J Heart Valve Dis, 1998, 7(2): 11-12.
13.	Tang GH, David TE, Singh SK, et al. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes. Circulation, 2006, 114(1): 1577-1581.
14.	Cohen G, Christakis GT, Joyner CD, et al. Are stentless valve hemodynamically superior to stented valve? A prospective randomized trial. Ann Thorac Surg, 2002, 73 (7): 67-68.
15.	Ali A, Halstead JC, Cafferty F, et al. Early clinical and hemodynamic outcomes after stented and stentless aortic valve replacement: results from a randomized controlled trial. Ann Thorac Surg, 2007, 83(2): 16-18.
16.	Meong Gun Song. Aortic valve reconstruction with leaflet replacement and sinotubular junction fixation: early and midterm results. Soc Thorac Surg, 2014, 9(7): 1239-1240.
17.	Pontefract DE, Iyengar SS. Prosthetic cardiac valves. Medicine, 2006, 3(4): 234-238.
18.	Padang R, Bagnall RD, Semsarian C. Gentic basis of familial valvular heart disease. Circ Cardiovasc Genet, 2012, 5(5): 569-580.
19.	Girdauskas E, Disha K, Raisin HH, et al. Risk of late aortic events after an isolated aortic valve replacement for bicuspid aortic valve stenosis with concomitan t ascending aortic dilation. Eur J Cardiothorac Surg, 2012, 42(5): 832-837.
20.	Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. Thorac Cardiovasc Surg, 2007, 13(3): 1226-1233.

1. Hahm SY, Choo SJ, Lee JW, et al. Novel technique of aortic valvuloplasty. Eur J Cardiothorac Surg, 2006, 29(5): 530-536.
2. 魏宇淼, 廖玉華, 王國榮, 等. 主動脈瓣疾病類型及變遷分析. 武漢大學學報醫學版, 2009, 30(3): 107-110.
3. Song MG. Aortic valve reconstruction with leaf replacement and sinotubular junction fixation early and midterm results. Soc Thorac Surg, 2014, 12(11): 154-156.
4. Song MG. Song innovative aortic root and valve reconstruction. Korea Koonja Publishing, 2013, 11(2): 236-238.
5. Tanigawa K, Eishi K, Yamachika S, et al. Comparison of the effects of aortic valve replacement using 19 mm Carpentier-Edwards Perimount bioprosthesis and 19 mm Medtronic Mosaic bioprosthesis. Ann Thorac Cardiovasc Surg, 2008, 14(8): 17.
6. Bernal JM, Pontyn A, Diaz B, et al. Combined mitral and tricuspid valve repair in rheumatic valve disease: fewer reoperations with prosthetic ring annuloplasty. Circulation, 2010, 12(8): 1934-1940.
7. Yoda M, Tanabe H, Kadoma Y, et al. Mid-term results of tricuspid annuloplasty using the MC3 ring for secondary tricuspid valve regurgitation. Interact Cardiovasc Thorac Surg, 2011, 13(1): 7-10.
8. 侯曉彤, 孟旭, 李偉, 等. 左心系統瓣膜替換術后遠期三尖瓣關閉不全的手術治療效果. 中華醫學雜志, 2005, 85(12): 3362-3364.
9. MeCarthy P, Bhudia S, Rajeswaran J. Tricuspid valve repair: durability and risk factors for failure. Thorac Cardiovasc Surg, 2004, 12(7): 674-685.
10. 潘世偉, 胡盛壽, 許建屏, 等. 成形軟環應用于三尖瓣關閉不全修復的療效評價. 中國循環雜志, 2009, 24(3): 379-382.
11. 宋邦榮, 來永強, 崔永超, 等. 主動脈瓣置換術后室間隔厚度對主動脈瓣跨瓣壓差的影響. 中華胸心血管外科雜志, 2012, 28(5): 282-284.
12. Pibarot P, Dumesnil JG, Lemieux M, et al. Impact of prosthesis patient mismatch on hemodynamic and symptomatic status, mot-bidity, and mortality after aortic valve replacement with a bioprostheticheart valve. J Heart Valve Dis, 1998, 7(2): 11-12.
13. Tang GH, David TE, Singh SK, et al. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes. Circulation, 2006, 114(1): 1577-1581.
14. Cohen G, Christakis GT, Joyner CD, et al. Are stentless valve hemodynamically superior to stented valve? A prospective randomized trial. Ann Thorac Surg, 2002, 73 (7): 67-68.
15. Ali A, Halstead JC, Cafferty F, et al. Early clinical and hemodynamic outcomes after stented and stentless aortic valve replacement: results from a randomized controlled trial. Ann Thorac Surg, 2007, 83(2): 16-18.
16. Meong Gun Song. Aortic valve reconstruction with leaflet replacement and sinotubular junction fixation: early and midterm results. Soc Thorac Surg, 2014, 9(7): 1239-1240.
17. Pontefract DE, Iyengar SS. Prosthetic cardiac valves. Medicine, 2006, 3(4): 234-238.
18. Padang R, Bagnall RD, Semsarian C. Gentic basis of familial valvular heart disease. Circ Cardiovasc Genet, 2012, 5(5): 569-580.
19. Girdauskas E, Disha K, Raisin HH, et al. Risk of late aortic events after an isolated aortic valve replacement for bicuspid aortic valve stenosis with concomitan t ascending aortic dilation. Eur J Cardiothorac Surg, 2012, 42(5): 832-837.
20. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. Thorac Cardiovasc Surg, 2007, 13(3): 1226-1233.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Technique of Comprehensive Aortic Root and Valve Reconstruction for Aortic Valve and Root Disease

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