Circulating Microemboli in Patients After Aortic Valve Replacement With Pulmonary Autografts and Mechanical Valve Prostheses

Abstract

In contrast to mechanical valves, pulmonary autografts are seldom the source of microemboli, confirming the pulmonary autograft as the superior substitute for aortic valve replacement.

Reoperations on the pulmonary autograft and pulmonary homograft after the Ross procedure: An update on the German Dutch Ross Registry

“…These benefits include survival comparable to that of the general population, freedom from lifelong anticoagulation, a superior quality of life, unrestricted daily activities, and normal aortic valve hemodynamics. [3][4][5][6][7]10 According to our current knowledge and estimations, not all Ross patients will require reoperation when treated with the SC technique ( Figure 6), which, at least in the period of the present study, provided the most robust longterm results.…”

“…Although the Ross procedure has been shown to offer numerous advantages, including freedom from lifelong anticoagulation, survival comparable to that of the general population, superior quality of life, unrestricted daily activities, and normal aortic valve hemodynamics, [1][2][3][4][5][6][7][8][9][10] the incidence of reoperation remains a concern. Together with the technical complexity of the procedure, the need for reoperations, on the autograft, the homograft, or both, has been the cornerstone of debate of whether the Ross procedure should be performed, especially in adult patients.…”

On the origin of microembolic signals

“…There were no clinical signs of Sneddon's syndrome in the whole patient population [28]. No patient had an artificial cardiac valve that may have confounded the results [12,20].…”

Argumente für Operationen an der Arteria carotis

“…Es bleibt festzuhalten, dass eine prospektive Einschätzung der Plaquemorphologie im Bereich der A. carotis meist nicht gelingt und dass dies vor allem für die emboliegefährlichen Mischformen des Plaques gilt. Hinzu kommt, dass bei einer Stentapplikation nachgewiesenermaßen massive Embolien ausgelöst werden, die in Form von HITS im transkraniellen Doppler nachgewiesen werden können (2,5,19) und in geringerem Ausmaß auch bei der chirurgischen Korrektur gefunden werden (16,17,19,27,28,35,41,46,47,53…”