Professional Documents
Culture Documents
Davidvsyacoubf 140720183943 Phpapp01
Davidvsyacoubf 140720183943 Phpapp01
operations
Dicky A.Wartono,MD
Aortic Surgery
• Conventional treatment of patients with aortic
root pathology—using a composite tube graft
• lifelong anticoagulation,
• risk of thromboembolism and bleeding,
• effects of cerebral microemboli,
If the. leaflets do not touch each other in the center, the graft may be too
large; this can he corrected by sewing the diameter of the sinotubular
junction.
Valve implantation:
slightly pulling on both the commissure and the
vascular graft before stitching the sutures through
the graft.
the graft should extend roughly by half of its
maximum length at this segment.
Insertion of saline allows a first judgment of
leakproofness of the valve.
The reimplantation of partially resected
sinuses of valsalvae starts at the Nadir of the
three coronary sinuses, each with double
armed monofila- ment sutures going up to
both commissures, where sutures were tied to
each other. This suture line must be
hemostatic! Stay sutures are tied and cut too.
. Valve-sparing aortic root replacement in patients with the Marfan syndrome. J Thorac Cardiovasc Surg
2003;125:773-778
• whether the reimplantation (David) technique or the
remodeling (Yacoub) technique provides the optimum
event free survival
• 14 papers provided the best evidence
• total of 1338 patients (Yacoub technique in 606 and
David technique in 732)
• 13 centres were included Interactive CardioVascular and Thoracic
Surgery 13 (2011) 189-197
J Thorac Cardiovasc Surg 2008;116:990-996
• Early mortality ranged from
– 0% to 6.9% for the Yacoub technique and
– Cusp repair
From the Departments of Cardiac Surgery, Medical University of Lübeck, Lübeck, Germany (R.G.L., C.S., H.-
H.S.), and the National Heart and Lung Institute at the Imperial College of Science, Technology, and Medicine,
London, UK (M.H.Y.).
EVOA is constant in both compliant and stiff
roots
RE-CREATION OF SINUSES IS IMPORTANT FOR SPARING THE
AORTIC VALVE: A FINITE ELEMENT STUDY
K. Jane Grande-Allen, PhDa, Richard P. Cochran, MDb, Per G.
Reinhall, PhDc, Karyn S. Kunzelman, PhDb