Five-year experience in aortic root replacement with the flanged composite graft

Kırali, Kaan; Mansuroğlu, Denyan; Erentuğ, Vedat; Mataracı, İlker; İpek, Gökhan; Alcıncı, Esat; Işık, Ömer; Yakut, Cevat

doi:10.1016/s0003-4975(01)03604-9

Cited by 32 publications

(26 citation statements)

References 15 publications

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“…Surgeons therefore opt for an early operation if life-threatening sequelae do not develop [20]. Most urgent surgical series have high mortality rates, ranging from 55% to 77% [14,21].…”

Section: Discussionmentioning

confidence: 99%

Rupture of Sinus of Valsalva with Endocarditis and Aortic Root Abscess

Ali¹,

Waseem²,

Arif³

2017

SOJMID

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A ruptured sinus of Valsalva aneurysm rarely accompanies the aortic valve endocarditis. A 40 year old female presented with low threshold exertional dyspnea and fever. Transthoracic and transesophageal echocardiography showed ruptured sinus of Valsalva aneurysm in right ventricle with multiple vegetations at the aortic root. Initial blood cultures were negative and an empirical antibiotic therapy was started. Patient was operated for surgical repair of sinus of Valsalva aneurysm.An aortic root abscess with rupture of sinus of Valsalva was found at operation. However, postoperatively she developed sepsis and multiorgan failure leading to her death.

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“…Surgeons therefore opt for an early operation if life-threatening sequelae do not develop [20]. Most urgent surgical series have high mortality rates, ranging from 55% to 77% [14,21].…”

Section: Discussionmentioning

confidence: 99%

Rupture of Sinus of Valsalva with Endocarditis and Aortic Root Abscess

Ali¹,

Waseem²,

Arif³

2017

SOJMID

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“…Kırali ve ark. [8] bu tekniğin kullanıldığı 96 hastalık çalış-mada %8.3 oranında (n=8) mortalite bildirmişlerdir, bunların üçü aşırı kanamaya bağlı gelişmiştir. Yine sekiz hastaya ameliyat sırası meydana gelen aşırı kanama nedeni ile tekrar kros klemp konulduğu, kanamanın iki hastada sol koroner ostiyal anastomozundan, bir hastada greftin proksimal anastomozundan kaynaklandığı bildirilirken beş hastada odağın bulunamadığı bildirilmiştir.…”

Section: Discussionunclassified

A new technique of proximal anastomosis in aortic root replacements with composite grafts: Flanged-double sewing anastomosis

Uzun¹

2015

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada etekli Bentall işlemini modifiye ederek yapmış olduğumuz etekli-çift kat proksimal anastomoz tekniğinin anastomoz kaynaklı olası kanamaları önlemede etkisi araştırıldı.Ça lış ma pla nı: Çalışmaya aort anevrizması ve aort kök genişlemesi olup Ocak 2010 -Ocak 2014 tarihleri arasında etekli kompozit greft ile aort kök replasmanı yapılan 13 hasta (11 erkek, 2 kadın, ort. yaş 53.54±16.09 yıl; dağılım 22-75 yıl) alındı. Dokuz hastada aort kapakta yetmezlik, iki hastada miks lezyon, iki hastada da normofonksiyonel biküspid kapak vardı. Tüm hastalarda çift kat dikişli proksimal anastomoz tekniği uygulandı. Koroner ostiyumlar buton tarzında hazırlanıp greftte açılan deliklere anastomoz edildi. Ostiyal anastomozlar greftin distal anastomozu yapılmadan önce antegrad kan kardiyoplejisi infüzyonu ile kontrol edildi.Bul gu lar: Mortalite olmadı. Hiçbir hastada kanama nedeniyle tekrar kros klemp yerleştirme gereksinimi olmadı. İki hasta kanama nedeniyle revizyona alındı, ancak bu kanamalar proksimal anastomoz hattı ve koroner buton anastomozları ile ilgili değildi. Bir hasta hafif nörolojik sekelle, 12 hasta tamamen iyileşmiş olarak taburcu edildi.So nuç: Etekli-çift kat proksimal anastomoz tekniği bu hattan kanama riskini minimuma indirebilir. Ayrıca, kros klemp kaldırılmadan önce antegrad kan kardiyoplejisi ile ostiyal anastomozları kontrol etmek aort kök replasmanlarında zorlayıcı kanamaları etkili bir şekilde önleyebilir.Anah tar söz cük ler: Aort kök replasmanı; kanama; kompozit greft; etekli Bentall işlemi. ABSTRACTBackground: This study aims to investigate the effect of flanged-double sewing proximal anastomosis technique, which is a modification of the flanged Bentall procedure, in preventing possible bleedings originating from anastomosis.

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“…Not only the aortic disease itself, but also the previous AVR make this type of aortic root replacement technically challenging. Mas- sive bleeding around the aortic root requires repeat cross-clamping, 7 which increases the risk of morbidity and mortality, so every effort must be made to minimize the bleeding. Thus, technical modifications to this procedure as a redo operation have important clinical implications.…”

Section: Discussionmentioning

confidence: 99%

“…3 Excision of the previous valve and placement of a composite valve conduit is another alternative, but this method is associated with a high risk of injuring the fragile annulus, which could cause massive bleeding from the proximal suture line. 7 Thus, we normally do not select this alternative. We used interrupted mattress sutures to secure the proximal anastomosis of the graft onto the aortic annulus, and then reinforced it by continuous suturing between the graft flange and the aortic wall remnant.…”

Section: Discussionmentioning

confidence: 99%

A Safer Technique of Aortic Root Replacement After Aortic Valve Replacement

et al. 2006

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Aortic root replacement after aortic valve replacement (AVR) is often complicated by bleeding around the aortic root, which increases the risk of morbidity and mortality, making it a technically challenging procedure. We describe a new technique of aortic root replacement designed to minimize bleeding around the aortic root. This surgical technique focuses on safe dissection and exposure of the aortic root to avoid inadvertent entry into the right atrium or right ventricle; on modifying the proximal anastomosis of the graft to the aortic annulus; and on performing a coronary artery reimplantation that achieves complete hemostasis at the suture lines. We performed aortic root replacement after AVR in four patients over a 4-year period, without encountering any bleeding around the aortic root.

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Five-year experience in aortic root replacement with the flanged composite graft

Cited by 32 publications

References 15 publications

Rupture of Sinus of Valsalva with Endocarditis and Aortic Root Abscess

Rupture of Sinus of Valsalva with Endocarditis and Aortic Root Abscess

A new technique of proximal anastomosis in aortic root replacements with composite grafts: Flanged-double sewing anastomosis

A Safer Technique of Aortic Root Replacement After Aortic Valve Replacement

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