By Charles Abraham Yankah, Yu-Guo Weng, Roland Hetzer
The surgical result of bioprosthetic aortic valve alternative within the Nineteen Sixties and Nineteen Seventies weren't very passable. the quest for the right alternative for the diseased aortic valve led Donald Ross to boost the idea that of the aortic allograft in 1962 and the pulmonary autograft in 1967 for subcoronary implantation, and later, in 1972, as a whole root for exchanging the aortic root within the contaminated aortic valve with a root abscess. The aortic al- graft and pulmonary autograft surgeries have been revo- tionary within the background of cardiac valve surgical procedure within the final m- lennium simply because they compete good with the bioprosthesis, are nonthrombogenic (thus, requiring no postoperative anticoa- lation), are immune to an infection, restoration the anatomic devices of the aortic or pulmonary outflow tract, and supply unimpeded blood stream and perfect hemodynamics, giving sufferers a b- ter diagnosis and caliber of existence. surgical procedure for congenital, degenerative, and inflammatory aortic valve and root illnesses has now reached a excessive point of adulthood; but an incredible valve for valve substitute isn't to be had. The- fore, surgeons are focusing their abilities and their medical and s- entific wisdom on optimizing the technical artistry of val- sparing tactics.
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Additional resources for Aortic Root Surgery: The Biological Solution
A Introduction of the unexpanded Edwards Sapien valve into the bioprosthesis after balloon dilatation. b Implanted self-expandable Edwards Sapien valve in the bioprosthesis z The aortic annulus The aortic annulus is the site where the ventricular musculature changes to that of the fibroelastic wall, the ventricular arterial junction to which the semilunar trileaflet aortic valve is attached. It represents the hemodynamic site between the left ventricle and the aorta. 17 18 z C. A. Yankah et al.
In case of a moderate to severe central leak, the implantation of a second transcatheter valve prosthesis (valve-in-a-valve) is the only option. The team approach is most important to safely implement a new technique even in high-risk patients. Optimal coordination during implantation is important, especially during critical steps of the procedure. Preoperative training is important and potential bailout strategies should be discussed by the team. Current strengths of the TA approach are the avoidance of the femoral arteries as well as a very low stroke risk due to minimal manipulations in the aortic arch.
References 1. Leboucq G (1944) Une anatomie antique du Coeur human. Philiston de Locroi et le timee’ de Plation. Rev Grecques 57:7 2. Sarton G (1952) A history of science. I Ancient science through the golden age of Greece. Harvard University Press, Cambridge, Massachusetts 3. Leonardo da Vinci (1977) Anatomical drawings from the Royal collections. The Royal Academy of Arts, London, p 35A 4. Valsalva AM (1740) Arteria magnae sinus. In: Morgagni JB (ed) Opera, pp 1–129 5. Siniawski H, Lehmkuhl H, Weng Y, Pasic M, Yankah C, Hoffman M, Behnke I, Hetzer R (2003) Stentless aortic valves as an alternative to homografts for valve replacement in active infective endocarditis complicated by ring abscess.