Abstract
Hemodynamically signifi cant aortic valve disease — both stenosis and regurgitation, regardless of its etiology — can be treated surgically. Adult patients with aortic stenosis require valve replacement with either mechanical or tissue valves. In patients with aortic regurgitation the valve can in some instances be repaired.
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Lewin MB, Otto CM (2005) The bicuspid aortic valve: adverse outcomes from infancy to old age. Circulation 111:832–834
Roberts WC, Vowels TJ, Ko JM (2009) Comparison of interpretations of valve structure between cardiac surgeon and cardiac pathologist among adults having isolated aortic valve replacement for aortic valve stenosis (±aortic regurgitation). Am J Cardiol 103:1139–1145
Bonow RO, Carabello BA, Kanu C, et al. (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease); developed in collaboration with the Society of Cardiovascular Anesthesiologists; endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 114:e84–e231
Vahanian A, Baumgartner H, Bax J et al. (2007) Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 28:230–268
Chambers J (2003) Low gradient, low ejection fraction aortic stenosis. Curr Treat Options Cardiovasc Med 5:469–474
Monin JL, Monchi M, Gest V et al. (2001) Aortic stenosis with severe left ventricular dysfunction and low transvalvular pressure gradients: risk stratification by low-dose dobutamine echocardiography. J Am Coll Cardiol 37:2101–2107
Subramanian H, Kunadian B, Dunning J (2008) Is it ever worth contemplating an aortic valve replacement on patients with low gradient severe aortic stenosis but poor left ventricular function with no contractile reserve? Interact Cardiovasc Thorac Surg 7:301–305
Piper C, Bergemann R, Schulte HD et al. (2003) Can progression of valvular aortic stenosis be predicted accurately? Ann Thorac Surg 76:676–680
Aris A, Camara ML, Montiel J et al. (1999) Ministernotomy versus median sternotomy for aortic valve replacement: a prospective, randomized study. Ann Thorac Surg 67:1583–1588
Bakir I, Casselman FP, Wellens F et al. (2006) Minimally invasive versus standard approach aortic valve replacement: a study in 506 patients. Ann Thorac Surg 81:1599–1604
Brown ML, McKellar SH, Sundt TM et al. (2009) Ministernotomy versus conventional sternotomy for aortic valve replacement: a systematic review and meta-analysis. J Thorac Cardiovasc Surg 137:670–679
Scarci M, Young C, Fallouh H (2009) Is ministernotomy superior to conventional approach for aortic valve replacement? Interact Cardiovasc Thorac Surg 9:314–317
Szwerc MF, Benckart DH, Wiechmann RJ et al. (1999) Partial versus full sternotomy for aortic valve replacement. Ann Thorac Surg 68:2209–2214
Tabata M, Umakanthan R, Cohn LH et al. (2008) Early and late outcomes of 1000 minimally invasive aortic valve operations. Eur J Cardiothorac Surg 33:537–541
Karimov JH, Santarelli F, Murzi M et al. (2009) A technique of an upper V-type ministernotomy in the second intercostal space. Interact Cardiovasc Thorac Surg 9:1021–1022
Minale C, Reifschneider HJ, Schmitz E et al. (1997) Single access for minimally invasive aortic valve replacement. Ann Thorac Surg 64:120–123
Nair RU, Sharpe DA (1998) Minimally invasive reversed Z sternotomy for aortic valve replacement. Ann Thorac Surg 65:1165–1166
Kleine P, Hasenkam MJ, Nygaard H et al. (2000) Tilting disc versus bileaflet aortic valve substitutes: intraoperative and post-operative hemodynamic performance in humans. J Heart Valve Dis 9:308–312
Laas J, Kleine P, Hasenkam MJ et al. (1999) Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics. Ann Thorac Surg 68:1096–1099
Botzenhardt F, Eichinger WB, Guenzinger R et al. (2005) Hemodynamic performance and incidence of patient–prosthesis mismatch of the complete supraannular perimount magna bioprosthesis in the aortic position. Thorac Cardiovasc Surg 53:226–230
Narang S, Satsangi DK, Banerjee A et al. (2008) Stentless valves versus stented bioprostheses at the aortic position: midterm results. J Thorac Cardiovasc Surg 136:943–947
Petracek MR (2002) Assessing options for the small aortic root. J Heart Valve Dis 11 (Suppl 1):S50–S55
Sintek CF, Fletcher AD, Khonsari S (1996) Small aortic root in the elderly: use of stentless bioprosthesis. J Heart Valve Dis 5 (Suppl 3):S308–S313
David TE, Uden DE (1983) Aortic valve replacement in adult patients with small aortic annuli. Ann Thorac Surg 36:577–583
Manhas DR, Stavney LS, Jones TW et al. (1980) Implantation of a larger aortic prosthetic valve in a patient with a small aortic annulus: an operative technique. Am Surg 46:597–599
Nicks R, Cartmill T, Bernstein L (1970) Hypoplasia of the aortic root. The problem of aortic valve replacement. Thorax 25:339–346
St. RammosK, DG Ketikoglou, GJKoullias et al.(2006) The Nicks–Nunez posterior enlargement in the small aortic annulus: immediate–intermediate results. Interact Cardiovasc Thorac Surg 5:749–753
Manouguian S, Seybold-Epting W (1979) Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet. New operative technique. J Thorac Cardiovasc Surg 78:402–412
Otaki M, Oku H, Nakamoto S et al. (1997) Two-directional aortic annular enlargement for aortic valve replacement in the small aortic annulus. Ann Thorac Surg 63:261–263
Konno S, Imai Y, Iida Y et al. (1975) A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring. J Thorac Cardiovasc Surg 70:909–917
Morrow AG, Brockenbrough EC (1961) Surgical treatment of idiopathic hypertrophic subaortic stenosis: technique and hemodynamic results of subaortic ventriculomyotomy. Ann Surg 154:181–189
Ross D (1991) Technique of aortic valve replacement with a homograft: orthotopic replacement. Ann Thorac Surg 52:154–156
Kilian E, Oberhoffer M, Gulbins H et al. (2004) Ten years' experience in aortic valve replacement with homografts in 389 cases. J Heart Valve Dis 13:554–559
Gill M, Dunning J (2009) Is reduction aortoplasty (with or without external wrap) an acceptable alternative to replacement of the dilated ascending aorta? Interact Cardiovasc Thorac Surg 9:693–697
Arsan S, Akgun S, Kurtoglu N et al. (2004) Reduction aortoplasty and external wrapping for moderately sized tubular ascending aortic aneurysm with concomitant operations. Ann Thorac Surg 78:858–861
Bauer M, Pasic M, Schaffarzyk R et al. (2002) Reduction aortoplasty for dilatation of the ascending aorta in patients with bicuspid aortic valve. Ann Thorac Surg 73:720–724
Cohen O, Odim J, Zerda D de la et al. (2007) Long-term experience of girdling the ascending aorta with Dacron mesh as definitive treatment for aneurysmal dilation. Ann Thorac Surg 83:S780–S790
Feindt P, Litmathe J, Borgens A et al. (2007) Is size-reducing ascending aortoplasty with external reinforcement an option in modern aortic surgery? Eur J Cardiothorac Surg 31:614–617
Maggio P, Carbone F, Lucchese G et al. (2008) Reduction aortoplasty: effective, useless or harmful? Results at 10 years. Interact Cardiovasc Thorac Surg 7:30
Kindo M, Billaud P, Gerelli S et al. (2007) Twenty-seven-year experience with composite valve graft replacement of the aortic root. J Heart Valve Dis 16:370–377
Bentall H, Bono A de (1968) A technique for complete replacement of the ascending aorta. Thorax 23:338–339
Cabrol C, Pavie A, Gandjbakhch I et al. (1981) Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J Thorac Cardiovasc Surg 81:309–315
Svensson LG (1992) Approach for insertion of aortic composite valve grafts. Ann Thorac Surg 54:376–378
De Robertis F, Asgar A, Davies S et al. (2009) The left axillary artery: a new approach for transcatheter aortic valve implantation. Eur J Cardiothorac Surg 36:807–812
Bleiziffer S, Ruge H, Mazzitelli D et al. (2009) Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team. Eur J Cardiothorac Surg 35:615–621
Mack MJ (2009) Transapical aortic valve implantation: Is it ready for prime time? Eur J Cardiothorac Surg 36:229–230
Vahanian A, Alfieri OR, Al-Attar N et al. (2008) Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg 34:1–8
Walther T, Falk V, Borger MA et al. (2007) Minimally invasive transapical beating heart aortic valve implantation: proof of concept. Eur J Cardiothorac Surg 31:9–15
Walther T, Falk V, Borger MA et al. (2009) Transapical aortic valve implantation in patients requiring redo surgery. Eur J Cardiothorac Surg 36:231–235
Walther T, Falk V, Kempfert J et al. (2008) Transapical minimally invasive aortic valve implantation: the initial 50 patients. Eur J Cardiothorac Surg 33:983–988
Borger MA, Preston M, Ivanov J et al. (2004) Should the ascending aorta be replaced more frequently in patients with bicuspid aortic valve disease? J Thorac Cardiovasc Surg 128:677–683
Parish LM, Gorman JH III, Kahn S et al. (2009) Aortic size in acute type A dissection: implications for preventive ascending aortic replacement. Eur J Cardiothorac Surg 35:941–946
Lansac E, Centa I di, Raoux F et al. (2008) A lesional classification to standardize surgical management of aortic insufficiency towards valve repair. Eur J Cardiothorac Surg 33:872–880
El Khoury G, Glineur D, Rubay J et al. (2005) Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Curr Opin Cardiol 20:115–121
Carpentier A (1983) Cardiac valve surgery: the “French correction.” J Thorac Cardiovasc Surg 86:323–337
Cosgrove DM, Rosenkranz ER, Hendren WG et al. (1991) Valvuloplasty for aortic insufficiency. J Thorac Cardiovasc Surg 102:571–577
El Khoury G, Vanoverschelde JL, Glineur D et al. (2004) Repair of aortic valve prolapse: experience with 44 patients. Eur J Cardiothorac Surg 26:628–633
Chiappini B, Pouleur AC, Noirhomme P et al. (2007) Repair of trileaflet aortic valve prolapse: mid-term outcome in patients with normal aortic root morphology. Interact Cardiovasc Thorac Surg 6:56–59
David TE, Armstrong S, Ivanov J et al. (1999) Aortic valve sparing operations: an update. Ann Thorac Surg 67:1840–1856
Ahn H, Kim KH, Kim YJ (2002) Midterm result of leaflet extension technique in aortic regurgitation. Eur J Cardiothorac Surg 21:465–469
Doss M, Moid R, Wood JP et al. (2005) Pericardial patch augmentation for reconstruction of incompetent bicuspid aortic valves. Ann Thorac Surg 80:304–307
Haydar HS, He GW, Hovaguimian H et al. (1997) Valve repair for aortic insufficiency: surgical classification and techniques. Eur J Cardiothorac Surg 11:258–265
Jeong DS, Kim KH, Ahn H (2009) Long-term results of the leaflet extension technique in aortic regurgitation: thirteen years of experience in a single center. Ann Thorac Surg 88:83–89
David TE, Feindel CM (1992) An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 103:617–622
Albes JM, Stock UA, Hartrumpf M (2005) Restitution of the aortic valve: What is new, what is proven, and what is obsolete? Ann Thorac Surg 80:1540–1549
Hopkins RA (2003) Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction. Eur J Cardiothorac Surg 24:886–897
Kallenbach K, Karck M, Pak D et al. (2005) Decade of aortic valve sparing reimplantation: Are we pushing the limits too far? Circulation 112:1253–1259
Sareyyupoglu B, Suri RM, Schaff HV et al. (2009) Survival and reoperation risk following bicuspid aortic valve-sparing root replacement. J Heart Valve Dis 18:1–8
Settepani F, Bergonzini M, Barbone A et al. (2009) Reimplantation valve-sparing aortic root replacement with the Valsalva graft: What have we learnt after 100 cases? Interact Cardiovasc Thorac Surg 9:113–116
Yacoub MH, Fagan A, Stassano P et al. (1983) Results of valve conserving operations for aortic regurgitation. Circulation 68:III-321.
Sarsam MA, Yacoub M (1993) Remodeling of the aortic valve annulus. J Thorac Cardiovasc Surg 105:435–438
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Dominik, J., Zacek, P. (2010). Aortic Valve Surgery. In: Heart Valve Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-12206-4_5
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DOI: https://doi.org/10.1007/978-3-642-12206-4_5
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