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Heart Valve Surgery pp 103–211Cite as

Aortic Valve Surgery

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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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References

  1. Lewin MB, Otto CM (2005) The bicuspid aortic valve: adverse outcomes from infancy to old age. Circulation 111:832–834

    Article  PubMed  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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

    PubMed  Google Scholar 

  5. Chambers J (2003) Low gradient, low ejection fraction aortic stenosis. Curr Treat Options Cardiovasc Med 5:469–474

    Article  PubMed  Google Scholar 

  6. 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

    Article  CAS  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. Piper C, Bergemann R, Schulte HD et al. (2003) Can progression of valvular aortic stenosis be predicted accurately? Ann Thorac Surg 76:676–680

    Article  PubMed  Google Scholar 

  9. 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

    Article  CAS  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. Scarci M, Young C, Fallouh H (2009) Is ministernotomy superior to conventional approach for aortic valve replacement? Interact Cardiovasc Thorac Surg 9:314–317

    Article  PubMed  Google Scholar 

  13. Szwerc MF, Benckart DH, Wiechmann RJ et al. (1999) Partial versus full sternotomy for aortic valve replacement. Ann Thorac Surg 68:2209–2214

    Article  CAS  PubMed  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. Minale C, Reifschneider HJ, Schmitz E et al. (1997) Single access for minimally invasive aortic valve replacement. Ann Thorac Surg 64:120–123

    Article  CAS  PubMed  Google Scholar 

  17. Nair RU, Sharpe DA (1998) Minimally invasive reversed Z sternotomy for aortic valve replacement. Ann Thorac Surg 65:1165–1166

    Article  CAS  PubMed  Google Scholar 

  18. 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

    CAS  PubMed  Google Scholar 

  19. 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

    Article  CAS  PubMed  Google Scholar 

  20. 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

    Article  CAS  PubMed  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. Petracek MR (2002) Assessing options for the small aortic root. J Heart Valve Dis 11 (Suppl 1):S50–S55

    PubMed  Google Scholar 

  23. 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

    PubMed  Google Scholar 

  24. David TE, Uden DE (1983) Aortic valve replacement in adult patients with small aortic annuli. Ann Thorac Surg 36:577–583

    CAS  PubMed  Google Scholar 

  25. 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

    CAS  PubMed  Google Scholar 

  26. Nicks R, Cartmill T, Bernstein L (1970) Hypoplasia of the aortic root. The problem of aortic valve replacement. Thorax 25:339–346

    Article  CAS  PubMed  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    CAS  PubMed  Google Scholar 

  29. 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

    Article  CAS  PubMed  Google Scholar 

  30. 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

    CAS  PubMed  Google Scholar 

  31. Morrow AG, Brockenbrough EC (1961) Surgical treatment of idiopathic hypertrophic subaortic stenosis: technique and hemodynamic results of subaortic ventriculomyotomy. Ann Surg 154:181–189

    Article  CAS  PubMed  Google Scholar 

  32. Ross D (1991) Technique of aortic valve replacement with a homograft: orthotopic replacement. Ann Thorac Surg 52:154–156

    Article  CAS  PubMed  Google Scholar 

  33. 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

    PubMed  Google Scholar 

  34. 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

    Article  PubMed  Google Scholar 

  35. 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

    Article  PubMed  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. 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

    Article  PubMed  Google Scholar 

  38. 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

    Article  PubMed  Google Scholar 

  39. 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

    Google Scholar 

  40. 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

    PubMed  Google Scholar 

  41. Bentall H, Bono A de (1968) A technique for complete replacement of the ascending aorta. Thorax 23:338–339

    Article  CAS  PubMed  Google Scholar 

  42. 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

    CAS  PubMed  Google Scholar 

  43. Svensson LG (1992) Approach for insertion of aortic composite valve grafts. Ann Thorac Surg 54:376–378

    Article  CAS  PubMed  Google Scholar 

  44. 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

    Article  PubMed  Google Scholar 

  45. 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

    Article  PubMed  Google Scholar 

  46. Mack MJ (2009) Transapical aortic valve implantation: Is it ready for prime time? Eur J Cardiothorac Surg 36:229–230

    Article  PubMed  Google Scholar 

  47. 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

    Article  PubMed  Google Scholar 

  48. 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

    Article  PubMed  Google Scholar 

  49. 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

    Article  PubMed  Google Scholar 

  50. 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

    Article  PubMed  Google Scholar 

  51. 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

    PubMed  Google Scholar 

  52. 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

    Article  PubMed  Google Scholar 

  53. 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

    Article  PubMed  Google Scholar 

  54. 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

    Article  CAS  PubMed  Google Scholar 

  55. Carpentier A (1983) Cardiac valve surgery: the “French correction.” J Thorac Cardiovasc Surg 86:323–337

    CAS  PubMed  Google Scholar 

  56. Cosgrove DM, Rosenkranz ER, Hendren WG et al. (1991) Valvuloplasty for aortic insufficiency. J Thorac Cardiovasc Surg 102:571–577

    CAS  PubMed  Google Scholar 

  57. 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

    Article  CAS  PubMed  Google Scholar 

  58. 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

    Article  PubMed  Google Scholar 

  59. David TE, Armstrong S, Ivanov J et al. (1999) Aortic valve sparing operations: an update. Ann Thorac Surg 67:1840–1856

    Article  CAS  PubMed  Google Scholar 

  60. Ahn H, Kim KH, Kim YJ (2002) Midterm result of leaflet extension technique in aortic regurgitation. Eur J Cardiothorac Surg 21:465–469

    Article  PubMed  Google Scholar 

  61. 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

    Article  PubMed  Google Scholar 

  62. 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

    Article  CAS  PubMed  Google Scholar 

  63. 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

    Article  PubMed  Google Scholar 

  64. 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

    CAS  PubMed  Google Scholar 

  65. 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

    Article  PubMed  Google Scholar 

  66. Hopkins RA (2003) Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction. Eur J Cardiothorac Surg 24:886–897

    Article  PubMed  Google Scholar 

  67. 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

    Google Scholar 

  68. 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

    PubMed  Google Scholar 

  69. 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

    Article  PubMed  Google Scholar 

  70. Yacoub MH, Fagan A, Stassano P et al. (1983) Results of valve conserving operations for aortic regurgitation. Circulation 68:III-321.

    Google Scholar 

  71. Sarsam MA, Yacoub M (1993) Remodeling of the aortic valve annulus. J Thorac Cardiovasc Surg 105:435–438

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiac Surgery, Charles University in Prague, 500 05, Hradec Kralove, Czech Republic

    Dr. Jan Dominik & Dr. Pavel Zacek

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  1. Dr. Jan Dominik
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  2. Dr. Pavel Zacek
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Correspondence to Pavel Zacek .

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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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