Preliminary Results with an Apico-Aortic Valved Conduit (AAVC) Using Polyurethane and Aortic Allograft Valves

Gerlach, K; Trautvetter, E.; Hennig, Ewald M.; Röcken, Friedrich

doi:10.3109/08941938809141096

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…In veterinary medicine, few canine case reports have been published for the same reason. According to the literature regarding AAVC, the problems associated with this method can be summarized as the following two points; 1) early death caused by perioperative or postoperative massive hemorrhage and other complications and 2) late death after surgery caused by an embolization of the conduit [3,9].…”

Section: Discussionmentioning

confidence: 99%

An Experimental Study of Apico-Aortic Valved Conduit (AAVC) for Surgical Treatment of Aortic Stenosis in Dogs

Hirao

Inoue

Hoshi

et al. 2005

The Journal of Veterinary Medical Science

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ABSTRACT. A new valved conduit was developed using a canine aortic valve. The bioprosthetic valve was fixed with glutaraldehyde and epoxy compound (Denacol-EX313/810). A vascular graft composed of ultra-fine polyester fiber (10 mm in diameter, 200 mm in length) was used. Four dogs underwent apico-aortic valved conduit (AAVC) implantation and aortic banding (bypass group, BG), while another 4 dogs underwent aortic banding without AAVC implantation (control group, CG). Cardiac catheterization and angiocardiography were performed for assessment of hemodynamics 2 weeks and 6 months after surgery. Left ventricular systolic pressure, left ventricular enddiastolic pressure and the left ventricular-aortic pressure gradient differed significantly (P<0.01) between the BG and CG dogs. Left ventricular angiocardiography showed patency of the valved conduit in all the BG dogs. Echocardiography was performed before and 2, 4 and 6 months after surgery, and showed that while pressure overload caused concentric myocardial hypertrophy in the CG dogs, the left ventricle dilated eccentrically in the BG dogs. Furthermore, relief of left ventricular pressure overload by AAVC was maintained. KEY WORDS: aortic banding, aortic stenosis, apico-aortic valved conduit, bioprosthetic valve.J. Vet. Med. Sci. 67(4): 357-362, 2005 Aortic stenosis (AS) is one of the most common congenital cardiac malformations observed in dogs, and the most frequently encountered cardiac disease, especially in large breeds. Of the three forms of AS, supravalvular, valvular and subvalvular, subvalvular aortic stenosis (SAS) is the most common form reported in dogs [2,4]. The clinical pathophysiology of all forms of AS, owing to left ventricular outflow tract obstruction (LVOTO), is an increase in left ventricular pressure overload and a pressure gradient across the obstruction. These factors cause left ventricular concentric hypertrophy and myocardial ischemia. The clinical signs of AS vary with the severity of the obstruction. While dogs with mild AS are asymptomatic, dogs with moderate to severe AS may have exercise intolerance, syncope and even sudden cardiac death occurring without premonitory signs.Medical therapy for AS, namely beta-adrenergic blockades or calcium channel antagonists have been empirically prescribed to improve diastolic dysfunction of the left ventricle and decrease myocardial oxygen demand [2,12]. However, their value is unproven. Since medical therapy is not effective for severely affected dogs, and they may often die suddenly, surgical relief of the LVOTO is recommended.Surgical treatment of AS in dogs includes closed transventricular dilation [15,18] and percutaneous transluminal balloon dilation [8,13]. However, these techniques may be inadequate for specific forms of AS, surgical dilation of lesions may produce regurgitation or increase preexistent regurgitation, and may introduce the possibility of recurrence after temporary relief of the condition.Thus, open resection of the obstructing lesions during cardiopulmonary bypass (CPB)...

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Section: Discussionmentioning

confidence: 99%

An Experimental Study of Apico-Aortic Valved Conduit (AAVC) for Surgical Treatment of Aortic Stenosis in Dogs

Hirao

Inoue

Hoshi

et al. 2005

The Journal of Veterinary Medical Science

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“…Similar operative approaches have been reported in the dog, beginning with transventricular dilation, progressing through removal of the shelf and myomectomy, and also using conduits placed from the apex of the left ventricle to the aorta. [202][203][204][205] As discussed at the beginning of this section, some are now introducing balloon dilation for relief of the short segment form of stenosis. This began with the experiences of Suarez de Lezo et al 206 and Labadibi et al 207 Most reports have been anecdotal, but some series of between 20 and 40 patients have been reported.…”

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

Thoughts about fixed subaortic stenosis in man and dog

et al. 2005

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T HE LESION PRODUCING THE TYPICALLY FIXED form of obstruction within the left ventricular outflow tract seemingly changes and evolves after birth. As we will discuss, patients exhibiting this characteristic exhibit some aspects of both acquired and congenital cardiac malformations. In these respects, canine subaortic stenosis is remarkably similar, especially as seen in the Newfoundland breed. Indeed, there is now a considerable literature devoted to subaortic stenosis in several mammalian species, including the cow and swine as well as the dog. 1-11 As far as the dog is concerned, the Newfoundland is but one of a number of breeds found to harbour the fascinating lesion that obstructs the left ventricular outflow tract. The lesion has also been found in boxers, rottweilers, golden retrievers, German shepherds, German shorthaired pointers, and Bouviers de Flandres. 6-11 In this review, we will discuss in detail this fixed type of subaortic stenosis as seen in the setting of an intact ventricular septum, addressing the underlying pathology, the evolving methodologies of investigation, and the results after surgical intervention. When germane, we will make comparisons with knowledge of subaortic stenosis as seen in the dog, particularly the Newfoundland. We have excluded from discussion, however, those patients with an atrioventricular septal defect in the setting of common atrioventricular junction. The Newfoundland breed The Newfoundland dog figures importantly in discussions about subaortic stenosis. The Newfoundland breed, 12,13 during the 19th century, became a status symbol for European society. Indeed, at one time this particular dog was the most popular canine import to Great Britain. The dogs themselves became instantly recognizable after Sir Edwin Landseer painted one of their numbers in 1838. The portrait was entitled "A Distinguished Member of the Humane Society" (Fig. 1). The dog in question was called Paul Pry, Landseer was paid £80 for his efforts, and the painting was eventually dedicated to the Royal Humane Society. 14,15 Historical perspective of subaortic stenosis It is the report of Norman C. Chevers, published in 1842, which is likely the earliest description of subaortic stenosis in man. 16 More than 80 years later,

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Preliminary Results with an Apico-Aortic Valved Conduit (AAVC) Using Polyurethane and Aortic Allograft Valves

Cited by 2 publications

References 11 publications

An Experimental Study of Apico-Aortic Valved Conduit (AAVC) for Surgical Treatment of Aortic Stenosis in Dogs

An Experimental Study of Apico-Aortic Valved Conduit (AAVC) for Surgical Treatment of Aortic Stenosis in Dogs

Thoughts about fixed subaortic stenosis in man and dog

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