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Surgical Treatment of Aortic Regurgitation with Preservation of the Aortic Valve

  • Jan Vojacek
  • Pavel Zacek
  • Jan Dominik
Chapter

Abstract

Regurgitant aortic valve in case of a suitable morphology and the absence of stenosis does not need to be replaced but its preservation and repair may be attempted. Conserving aortic valve at surgery enables the patient to avoid antithrombotic therapy and minimalize complex valve-related risks for the long term. Aortic regurgitation is a complex result of aortic leaflets pathology and/or dilation pathology of the aortic root and ascending aorta. According to concrete patient pathology, reconstructive surgical interventions address three principal zones (aortic annulus, aortic leaflets, sinotubular junction—ascending aorta). A complex armamentarium of valve-sparing surgical interventions is discussed in detail, including also extraaortic conservative approaches.

Keywords

Aortic valve repair Reimplantation of the aortic valve Remodelling of the aortic root Cusp plication Aortic wrapping 

References

  1. 1.
    Bierbach BO, Aicher D, Issa OA, et al. Aortic root and cusp configuration determine aortic valve function. Eur J Cardiothorac Surg. 2010;38:400–6.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Cabrol C, Cabrol A, Guiraudon G, et al. Treatment of aortic insufficiency by means of aortic annuloplasty. Arch Mal Coeur Vaiss. 1966;59:1305–12.PubMedGoogle Scholar
  3. 3.
    David TE, Feindel CM, Armstrong S, et al. Replacement of the ascending aorta with reduction of the diameter of the sinotubular junction to treat aortic insufficiency in patients with ascending aortic aneurysm. J Thorac Cardiovasc Surg. 2007;133:414–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Asano M, Kunihara T, Aicher D, et al. Mid-term results after sinutubular junction remodelling with aortic cusp repair. Eur J Cardiothorac Surg. 2012;42:1010–5.PubMedCrossRefGoogle Scholar
  5. 5.
    de Kerchove L, Jashari R, Boodhwani M, et al. Surgical anatomy of the aortic root: implication for valve-sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surg. 2015;149:425–33.PubMedCrossRefGoogle Scholar
  6. 6.
    Khelil N, Sleilaty G, Palladino M, et al. Surgical anatomy of the aortic annulus: landmarks for external annuloplasty in aortic valve repair. Ann Thorac Surg. 2015;99(4):1220–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Aicher D, Kunihara T, Abou Issa O, et al. Valve configuration determines long-term results after repair of the bicuspid aortic valve. Circulation. 2011;123:178–85.PubMedCrossRefGoogle Scholar
  8. 8.
    Hanke T, Charitos EI, Stierle U, et al. Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery. J Thorac Cardiovasc Surg. 2009;137:314–9.CrossRefPubMedGoogle Scholar
  9. 9.
    de Kerchove L, Mastrobuoni S, Boodhwani M, et al. The role of annular dimension and annuloplasty in tricuspid aortic valve repair. Eur J Cardiothorac Surg. 2016;49:428–37. discussion 437–8PubMedCrossRefGoogle Scholar
  10. 10.
    Schafers HJ, Raddatz A, Schmied W, et al. Reexamining remodeling. J Thorac Cardiovasc Surg. 2015;149:S30–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Kunihara T, Aicher D, Rodionycheva S, et al. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg. 2012;143:1389–95.CrossRefPubMedGoogle Scholar
  12. 12.
    de Kerchove L, Vismara R, Mangini A, et al. In vitro comparison of three techniques for ventriculo-aortic junction annuloplasty. Eur J Cardiothorac Surg. 2012;41:1117–23. discussion 1123–4PubMedCrossRefGoogle Scholar
  13. 13.
    Navarra E, El Khoury G, Glineur D, et al. Effect of annulus dimension and annuloplasty on bicuspid aortic valve repair. Eur J Cardiothorac Surg. 2013;44:316–23.PubMedCrossRefGoogle Scholar
  14. 14.
    Ng AC, Delgado V, van der Kley F, et al. Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging. 2010;3:94–102.PubMedCrossRefGoogle Scholar
  15. 15.
    Messika-Zeitoun D, Serfaty JM, Brochet E, et al. Multimodal assessment of the aortic annulus diameter: implications for transcatheter aortic valve implantation. J Am Coll Cardiol. 2010;55:186–94.PubMedCrossRefGoogle Scholar
  16. 16.
    Gallo R, Kumar N, al Halees Z, et al. Early failure of aortic valve conservation in aortic root aneurysm. J Thorac Cardiovasc Surg. 1995;109:1011–2. discussion 1013CrossRefPubMedGoogle Scholar
  17. 17.
    Lansac E, Di Centa I. From dynamic anatomy to conservative aortic valve surgery: the tale of the ring. In: Yankah AC, Weng Y, Hetzer R, editors. Aortic root surgery. Berlin: Springer; 2010. p. 102–32.CrossRefGoogle Scholar
  18. 18.
    Taylor WJ, Thrower WB, Black H, et al. The surgical correction of aortic insufficiency by circumclusion. J Thorac Surg. 1958;35:192–205 passim.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Carpentier A. Cardiac valve surgery--the “French correction”. J Thorac Cardiovasc Surg. 1983;86:323–37.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Miller DC. Valve-sparing aortic root replacement in patients with the Marfan syndrome. J Thorac Cardiovasc Surg. 2003;125:773–8.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    El Khoury GA, Underwood MJ, Glineur D, et al. Reconstruction of the ascending aorta and aortic root: experience in 45 consecutive patients. Ann Thorac Surg. 2000;70:1246–50.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Lansac E, Di Centa I, Varnous S, et al. External aortic annuloplasty ring for valve-sparing procedures. Ann Thorac Surg. 2005;79:356–8.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Aicher D, Schneider U, Schmied W, et al. Early results with annular support in reconstruction of the bicuspid aortic valve. J Thorac Cardiovasc Surg. 2013;145:S30–4.CrossRefPubMedGoogle Scholar
  24. 24.
    Schneider U, Aicher D, Miura Y, et al. Suture annuloplasty in aortic valve repair. Ann Thorac Surg. 2016;101:783–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Fattouch K, Sampognaro R, Speziale G, et al. New technique for aortic valve functional annulus reshaping using a handmade prosthetic ring. Ann Thorac Surg. 2011;91:1154–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Mazzitelli D, Nobauer C, Rankin JS, et al. Early results of a novel technique for ring-reinforced aortic valve and root restoration. Eur J Cardiothorac Surg. 2014;45:426–30.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Mazzitelli D, Pfeiffer S, Rankin JS, et al. A regulated trial of bicuspid aortic valve repair supported by geometric ring annuloplasty. Ann Thorac Surg. 2015;99:2010–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Holubec T, Higashigaito K, Belobradek Z et al. (2016) An expansible aortic ring in aortic root remodeling: exact position, pulsatility, effectiveness, and stability in three-dimensional CT study. Ann Thorac Surg.Google Scholar
  29. 29.
    Romagnoni C, Mangini A, Vismara R, et al. Aortic interleaflet triangles reshaping: hydrodynamic, kinematic and morphological effects in in-vitro analysis. J Heart Valve Dis. 2014;23:424–31.PubMedGoogle Scholar
  30. 30.
    Lansac E, Di Centa I, Raoux F, et al. An expansible aortic ring for a physiological approach to conservative aortic valve surgery. J Thorac Cardiovasc Surg. 2009;138:718–24.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Lansac E, Di Centa I, Sleilaty G, et al. An aortic ring: from physiologic reconstruction of the root to a standardized approach for aortic valve repair. J Thorac Cardiovasc Surg. 2010;140:S28–35;discussion S45-51PubMedCrossRefGoogle Scholar
  32. 32.
    Schafers HJ, Langer F, Aicher D, et al. Remodeling of the aortic root and reconstruction of the bicuspid aortic valve. Ann Thorac Surg. 2000;70:542–6.PubMedCrossRefGoogle Scholar
  33. 33.
    Schafers HJ, Schmied W, Marom G, et al. Cusp height in aortic valves. J Thorac Cardiovasc Surg. 2013;146:269–74.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Schafers HJ, Bierbach B, Aicher D. A new approach to the assessment of aortic cusp geometry. J Thorac Cardiovasc Surg. 2006;132:436–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Frater RW. The prolapsing aortic cusp. Experimental and clinical observations. Ann Thorac Surg. 1967;3:63–7.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Lansac E, Di Centa I, Vojacek J, et al. Valve sparing root replacement: the remodeling technique with external ring annuloplasty. Ann Cardiothorac Surg. 2013;2:117–23.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Trusler GA, Moes CA, Kidd BS. Repair of ventricular septal defect with aortic insufficiency. J Thorac Cardiovasc Surg. 1973;66:394–403.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Marom G, Haj-Ali R, Rosenfeld M, et al. Aortic root numeric model: correlation between intraoperative effective height and diastolic coaptation. J Thorac Cardiovasc Surg. 2013;145:303–4.CrossRefPubMedGoogle Scholar
  39. 39.
    Gnyaneshwar R, Kumar RK, Balakrishnan KR. Dynamic analysis of the aortic valve using a finite element model. Ann Thorac Surg. 2002;73:1122–9.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Sabet HY, Edwards WD, Tazelaar HD, et al. Congenitally bicuspid aortic valves: a surgical pathology study of 542 cases (1991 through 1996) and a literature review of 2,715 additional cases. Mayo Clin Proc. 1999;74:14–26.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg. 2007;133:1226–33.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Schafers HJ, Aicher D, Riodionycheva S, et al. Bicuspidization of the unicuspid aortic valve: a new reconstructive approach. Ann Thorac Surg. 2008;85:2012–8.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Franciulli M, Aicher D, Radle-Hurst T, et al. Root remodeling and aortic valve repair for unicuspid aortic valve. Ann Thorac Surg. 2014;98:823–9.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Erbel R, Aboyans V, Boileau C, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2873–926.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968;23:338–9.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Yacoub MH, Fagan A, Stassano P, et al. Results of valve conserving operations for aortic regurgitation (abstract). Circulation. 1983;68:311–2.Google Scholar
  47. 47.
    David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1992;103:617–21. discussion 622PubMedGoogle Scholar
  48. 48.
    Shrestha M, Krueger H, Umminger J, et al. Minimally invasive valve sparing aortic root replacement (David procedure) is safe. Ann Cardiothorac Surg. 2015;4:148–53.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Hutchins GM, Nazarian IH, Bulkley BH. Association of left dominant coronary arterial system with congenital bicuspid aortic valve. Am J Cardiol. 1978;42:57–9.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Berdajs D, Lajos P, Turina M. The anatomy of the aortic root. Cardiovasc Surg. 2002;10:320–7.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg. 1993;105:435–8.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Fagan A, Pillai R, Radley-Smith R, et al. Results of new valve conserving operation for treatment of aneurysms or acute dissection of aortic root. Br Heart J. 1983;49:302.Google Scholar
  53. 53.
    Thubrikar M, Piepgrass WC, Shaner TW, et al. The design of the normal aortic valve. Am J Phys. 1981;241:H795–801.Google Scholar
  54. 54.
    Yacoub MH, Gehle P, Chandrasekaran V, et al. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg. 1998;115:1080–90.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Erasmi AW, Sievers HH, Bechtel JF, et al. Remodeling or reimplantation for valve-sparing aortic root surgery? Ann Thorac Surg. 2007;83:S752–6. discussion S785–90PubMedCrossRefGoogle Scholar
  56. 56.
    Cameron DE, Alejo DE, Patel ND, et al. Aortic root replacement in 372 Marfan patients: evolution of operative repair over 30 years. Ann Thorac Surg. 2009;87:1344–9. discussion 1349–50PubMedCrossRefGoogle Scholar
  57. 57.
    Leyh RG, Fischer S, Kallenbach K, et al. High failure rate after valve-sparing aortic root replacement using the “remodeling technique” in acute type a aortic dissection. Circulation. 2002;106:I229–33.PubMedGoogle Scholar
  58. 58.
    De Paulis R, De Matteis GM, Nardi P, et al. Opening and closing characteristics of the aortic valve after valve-sparing procedures using a new aortic root conduit. Ann Thorac Surg. 2001;72:487–94.PubMedCrossRefGoogle Scholar
  59. 59.
    Hahm SY, Choo SJ, Lee JW, et al. Novel technique of aortic valvuloplasty. Eur J Cardiothorac Surg. 2006;29:530–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Wuliya M, Sleilaty G, Di Centa I, et al. An expansible aortic ring to preserve aortic root dynamics after aortic valve repair. Eur J Cardiothorac Surg. 2015;47:482–90;discussion 490PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Lansac E, Di Centa I, Sleilaty G, et al. Long-term results of external aortic ring annuloplasty for aortic valve repair. Eur J Cardiothorac Surg. 2016;50:350–60.PubMedCrossRefGoogle Scholar
  62. 62.
    Contino M, Mangini A, Lemma MG, et al. A geometric approach to aortic root surgical anatomy. Eur J Cardiothorac Surg. 2016;49:93–100.PubMedCrossRefGoogle Scholar
  63. 63.
    David TE. The aortic valve-sparing operation. J Thorac Cardiovasc Surg. 2011;141:613–5.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    David TE, Pollick C, Bos J. Aortic valve replacement with stentless porcine aortic bioprosthesis. J Thorac Cardiovasc Surg. 1990;99:113–8.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Cochran RP, Kunzelman KS, Eddy AC, et al. Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1995;109:1049–57. discussion 1057-8PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Grande-Allen KJ, Cochran RP, Reinhall PG, et al. Re-creation of sinuses is important for sparing the aortic valve: a finite element study. J Thorac Cardiovasc Surg. 2000;119:753–63.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Ergin MA, Griepp RB. When, why, and how should the native aortic valve be preserved in patients with annuloaortic ectasia or Marfan syndrome? Semin Thorac Cardiovasc Surg. 1993;5:91–2.PubMedGoogle Scholar
  68. 68.
    Demers P, Miller DC. Simple modification of “T. David-V” valve-sparing aortic root replacement to create graft pseudosinuses. Ann Thorac Surg. 2004;78:1479–81.PubMedCrossRefGoogle Scholar
  69. 69.
    De Paulis R, De Matteis GM, Nardi P, et al. Analysis of valve motion after the reimplantation type of valve-sparing procedure (David I) with a new aortic root conduit. Ann Thorac Surg. 2002;74:53–7.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    De Paulis R, De Matteis GM, Nardi P, et al. One-year appraisal of a new aortic root conduit with sinuses of Valsalva. J Thorac Cardiovasc Surg. 2002;123:33–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Boodhwani M, de Kerchove L, Watremez C, et al. Assessment and repair of aortic valve cusp prolapse: implications for valve-sparing procedures. J Thorac Cardiovasc Surg. 2011;141:917–25.PubMedCrossRefGoogle Scholar
  72. 72.
    Van Dyck M, Glineur D, de Kerchove L, et al. Complications after aortic valve repair and valve-sparing procedures. Ann Cardiothorac Surg. 2013;2:130–9.PubMedPubMedCentralGoogle Scholar
  73. 73.
    le Polain de Waroux JB, Pouleur AC, Robert A, et al. Mechanisms of recurrent aortic regurgitation after aortic valve repair: predictive value of intraoperative transesophageal echocardiography. JACC Cardiovasc Imaging. 2009;2:931–9.PubMedCrossRefGoogle Scholar
  74. 74.
    Pethig K, Milz A, Hagl C, et al. Aortic valve reimplantation in ascending aortic aneurysm: risk factors for early valve failure. Ann Thorac Surg. 2002;73:29–33.PubMedCrossRefGoogle Scholar
  75. 75.
    Nash PJ, Vitvitsky E, Li J, et al. Feasibility of valve repair for regurgitant bicuspid aortic valves--an echocardiographic study. Ann Thorac Surg. 2005;79:1473–9.PubMedCrossRefGoogle Scholar
  76. 76.
    Svensson LG, Al Kindi AH, Vivacqua A, et al. Long-term durability of bicuspid aortic valve repair. Ann Thorac Surg. 2014;97:1539–47; discussion 1548PubMedCrossRefGoogle Scholar
  77. 77.
    Vohra HA, Whistance RN, de Kerchove L, et al. Influence of higher valve gradient on long-term outcome after aortic valve repair. Ann Cardiothorac Surg. 2013;2:30–9.PubMedPubMedCentralGoogle Scholar
  78. 78.
    Aicher D, Bewarder M, Kindermann M, et al. Aortic valve function after bicuspidization of the unicuspid aortic valve. Ann Thorac Surg. 2013;95:1545–50.PubMedCrossRefGoogle Scholar
  79. 79.
    Aicher D, Langer F, Adam O, et al. Cusp repair in aortic valve reconstruction: does the technique affect stability? J Thorac Cardiovasc Surg. 2007;134:1533–8; discussion 1538-9PubMedCrossRefGoogle Scholar
  80. 80.
    de Kerchove L, Boodhwani M, Glineur D, et al. Cusp prolapse repair in trileaflet aortic valves: free margin plication and free margin resuspension techniques. Ann Thorac Surg. 2009;88:455–61; discussion 461PubMedCrossRefGoogle Scholar
  81. 81.
    Al Halees Z, Al Shahid M, Al Sanei A, et al. Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve? Eur J Cardiothorac Surg. 2005;28:200–5. discussion 205PubMedCrossRefGoogle Scholar
  82. 82.
    Holubec T, Zacek P, Jamaliramin M, et al. Valve cuspidity: a risk factor for aortic valve repair? J Card Surg. 2014;29:585–92.PubMedCrossRefGoogle Scholar
  83. 83.
    Schafers HJ, Kunihara T, Fries P, et al. Valve-preserving root replacement in bicuspid aortic valves. J Thorac Cardiovasc Surg. 2010;140:S36–40; discussion S45–51PubMedCrossRefGoogle Scholar
  84. 84.
    Boodhwani M, de Kerchove L, Glineur D, et al. Repair of regurgitant bicuspid aortic valves: a systematic approach. J Thorac Cardiovasc Surg. 2010;140:276–284 e1.PubMedCrossRefGoogle Scholar
  85. 85.
    Vohra HA, Whistance RN, De Kerchove L, et al. Valve-preserving surgery on the bicuspid aortic valve. Eur J Cardiothorac Surg. 2013;43:888–98.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Jasinski MJ, Gocol R, Scott Rankin J, et al. Long-term outcomes after aortic valve repair and associated aortic root reconstruction. J Heart Valve Dis. 2014;23:414–23.PubMedGoogle Scholar
  87. 87.
    Jasinski MJ, Gocol R, Malinowski M, et al. Predictors of early and medium-term outcome of 200 consecutive aortic valve and root repairs. J Thorac Cardiovasc Surg. 2015;149:123–9.PubMedCrossRefGoogle Scholar
  88. 88.
    Bavaria JE, Desai N, Szeto WY, et al. Valve-sparing root reimplantation and leaflet repair in a bicuspid aortic valve: comparison with the 3-cusp David procedure. J Thorac Cardiovasc Surg. 2015;149:S22–8.PubMedCrossRefGoogle Scholar
  89. 89.
    El Khoury G, Vanoverschelde JL, Glineur D, et al. Repair of bicuspid aortic valves in patients with aortic regurgitation. Circulation. 2006;114:I610–6.PubMedCrossRefGoogle Scholar
  90. 90.
    Aicher D, Schafers HJ (2010) Bicuspidization of the regurgitant unicuspid aortic valve. Multimed Man Cardiothorac Surg. 2010:mmcts 2009 004069.Google Scholar
  91. 91.
    David TE, Ivanov J, Armstrong S, et al. Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta. Ann Thorac Surg. 2002;74:S1758–61. discussion S1792-9PubMedCrossRefGoogle Scholar
  92. 92.
    David TE, Feindel CM, Webb GD, et al. Long-term results of aortic valve-sparing operations for aortic root aneurysm. J Thorac Cardiovasc Surg. 2006;132:347–54.PubMedCrossRefGoogle Scholar
  93. 93.
    David TE, Maganti M, Armstrong S. Aortic root aneurysm: principles of repair and long-term follow-up. J Thorac Cardiovasc Surg. 2010;140:S14–9. discussion S45-51PubMedCrossRefGoogle Scholar
  94. 94.
    David TE, Feindel CM, David CM, et al. A quarter of a century of experience with aortic valve-sparing operations. J Thorac Cardiovasc Surg. 2014;148:872–9. discussion 879–80PubMedCrossRefGoogle Scholar
  95. 95.
    Arabkhani B, Mookhoek A, Di Centa I, et al. Reported outcome after valve-sparing aortic root replacement for aortic root aneurysm: a systematic review and meta-analysis. Ann Thorac Surg. 2015;100:1126–31.CrossRefPubMedGoogle Scholar
  96. 96.
    Schafers H, Fries R, Langer F, et al. Valve-preserving replacement of the ascending aorta: remodeling versus reimplantation. J Thorac Cardiovasc Surg. 1998;116:990–6.PubMedCrossRefGoogle Scholar
  97. 97.
    Lausberg HF, Schafers HJ (2006) Valve sparing aortic replacement - root remodeling. Multimed Man Cardiothorac Surg. 2006:mmcts 2006 001982.Google Scholar
  98. 98.
    Aicher D, Langer F, Lausberg H, et al. Aortic root remodeling: ten-year experience with 274 patients. J Thorac Cardiovasc Surg. 2007;134:909–15.PubMedCrossRefGoogle Scholar
  99. 99.
    Kunihara T, Neumann N, Kriechbaum SD, et al. Aortic root remodeling leads to good valve stability in acute aortic dissection and preexistent root dilatation. J Thorac Cardiovasc Surg. 2016;152(2):430–436.e1.PubMedCrossRefGoogle Scholar
  100. 100.
    Lansac E, Di Centa I, Sleilaty G, et al. An aortic ring to standardise aortic valve repair: preliminary results of a prospective multicentric cohort of 144 patients. Eur J Cardiothorac Surg. 2010;38:147–54.PubMedPubMedCentralCrossRefGoogle Scholar
  101. 101.
    David TE, Feindel CM, Webb GD, et al. Aortic valve preservation in patients with aortic root aneurysm: results of the reimplantation technique. Ann Thorac Surg. 2007;83:S732–5; discussion S785-90PubMedCrossRefGoogle Scholar
  102. 102.
    David TE, Armstrong S, Manlhiot C, et al. Long-term results of aortic root repair using the reimplantation technique. J Thorac Cardiovasc Surg. 2013;145:S22–5.PubMedCrossRefGoogle Scholar
  103. 103.
    Kvitting JP, Kari FA, Fischbein MP, et al. David valve-sparing aortic root replacement: equivalent mid-term outcome for different valve types with or without connective tissue disorder. J Thorac Cardiovasc Surg. 2013;145:117–26. 127 e1–5; discussion 126–7PubMedCrossRefGoogle Scholar
  104. 104.
    Boodhwani M, de Kerchove L, El Khoury G. Aortic root replacement using the reimplantation technique: tips and tricks. Interact Cardiovasc Thorac Surg. 2009;8:584–6.PubMedCrossRefGoogle Scholar
  105. 105.
    Vallabhajosyula P, Komlo C, Szeto WY, et al. Root stabilization of the repaired bicuspid aortic valve: subcommissural annuloplasty versus root reimplantation. Ann Thorac Surg. 2014;97:1227–34.PubMedCrossRefGoogle Scholar
  106. 106.
    De Paulis R, Chirichilli I, Scaffa R, et al. Long-term results of the valve reimplantation technique using a graft with sinuses. J Thorac Cardiovasc Surg. 2016;151:112–9.PubMedCrossRefGoogle Scholar
  107. 107.
    Saczkowski R, Malas T, de Kerchove L, et al. Systematic review of aortic valve preservation and repair. Ann Cardiothorac Surg. 2013;2:3–9.PubMedPubMedCentralGoogle Scholar
  108. 108.
    Kari FA, Doll KN, Hemmer W, et al. Survival and freedom from aortic valve-related reoperation after valve-sparing aortic root replacement in 1015 patients. Interact Cardiovasc Thorac Surg. 2016;22:431–8.PubMedCrossRefGoogle Scholar
  109. 109.
    Birks EJ, Webb C, Child A, et al. Early and long-term results of a valve-sparing operation for Marfan syndrome. Circulation. 1999;100:II29–35.CrossRefPubMedGoogle Scholar
  110. 110.
    David TE, Armstrong S, Maganti M, et al. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome. J Thorac Cardiovasc Surg. 2009;138:859–64. discussion 863–4PubMedCrossRefGoogle Scholar
  111. 111.
    David TE, David CM, Manlhiot C, et al. Outcomes of aortic valve-sparing operations in Marfan syndrome. J Am Coll Cardiol. 2015;66:1445–53.PubMedCrossRefGoogle Scholar
  112. 112.
    Benedetto U, Melina G, Takkenberg JJ, et al. Surgical management of aortic root disease in Marfan syndrome: a systematic review and meta-analysis. Heart. 2011;97:955–8.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Erasmi AW, Stierle U, Bechtel JF, et al. Up to 7 years’ experience with valve-sparing aortic root remodeling/reimplantation for acute type a dissection. Ann Thorac Surg. 2003;76:99–104.PubMedCrossRefGoogle Scholar
  114. 114.
    Subramanian S, Leontyev S, Borger MA, et al. Valve-sparing root reconstruction does not compromise survival in acute type a aortic dissection. Ann Thorac Surg. 2012;94:1230–4.PubMedCrossRefGoogle Scholar
  115. 115.
    Robicsek F, Daugherty HK, Mullen DC, et al. Long-range observations with external aortic grafts. J Cardiovasc Surg. 1976;17:195–201.Google Scholar
  116. 116.
    Robicsek F. A new method to treat fusiform aneurysms of the ascending aorta associated with aortic valve disease: an alternative to radical resection. Ann Thorac Surg. 1982;34:92–4.PubMedCrossRefGoogle Scholar
  117. 117.
    Carrel T, von Segesser L, Jenni R, et al. Dealing with dilated ascending aorta during aortic valve replacement: advantages of conservative surgical approach. Eur J Cardiothorac Surg. 1991;5:137–43.PubMedCrossRefGoogle Scholar
  118. 118.
    Harrison LH Jr, Heck HA Jr. Shawl lapel aortoplasty. Ann Thorac Surg. 1996;62:1867.PubMedCrossRefGoogle Scholar
  119. 119.
    Cotrufo M, Della Corte A, De Santo LS, et al. Asymmetric medial degeneration of the ascending aorta in aortic valve disease: a pilot study of surgical management. J Heart Valve Dis. 2003;12:127–33. discussion 134-5PubMedGoogle Scholar
  120. 120.
    Baumgartner F, Pak S, Ginzton L, et al. Reduction aortoplasty for moderate-sized ascending aortic aneurysms. Ann Thorac Surg. 1995;59:268.PubMedCrossRefGoogle Scholar
  121. 121.
    Bauer M, Pasic M, Schaffarzyk R, et al. Reduction aortoplasty for dilatation of the ascending aorta in patients with bicuspid aortic valve. Ann Thorac Surg. 2002;73:720–3. discussion 724PubMedCrossRefGoogle Scholar
  122. 122.
    Barnett MG, Fiore AC, Vaca KJ, et al. Tailoring aortoplasty for repair of fusiform ascending aortic aneurysms. Ann Thorac Surg. 1995;59:497–51.PubMedCrossRefGoogle Scholar
  123. 123.
    Cohen O, Odim J, De la Zerda D, et al. Long-term experience of girdling the ascending aorta with Dacron mesh as definitive treatment for aneurysmal dilation. Ann Thorac Surg. 2007;83:S780–4. discussion S785-90PubMedPubMedCentralCrossRefGoogle Scholar
  124. 124.
    Arsan S, Akgun S, Kurtoglu N, et al. Reduction aortoplasty and external wrapping for moderately sized tubular ascending aortic aneurysm with concomitant operations. Ann Thorac Surg. 2004;78:858–61.PubMedCrossRefGoogle Scholar
  125. 125.
    Akgun S, Atalan N, Fazliogullari O, et al. Aortic root aneurysm after off-pump reduction aortoplasty. Ann Thorac Surg. 2010;90:e69–70.PubMedCrossRefGoogle Scholar
  126. 126.
    Bauer M, Grauhan O, Hetzer R. Dislocated wrap after previous reduction aortoplasty causes erosion of the ascending aorta. Ann Thorac Surg. 2003;75:583–4.PubMedCrossRefGoogle Scholar
  127. 127.
    Dhillon JS, Randhawa GK, Straehley CJ, et al. Late rupture after dacron wrapping of aortic aneurysms. Circulation. 1986;74:I11–4.PubMedGoogle Scholar
  128. 128.
    Plonek T. A metaanalysis and systematic review of wrapping of the ascending aorta. J Card Surg. 2014;29:809–15.PubMedCrossRefGoogle Scholar
  129. 129.
    Pecoraro F, Shingaki M, Steuer J, et al. Treatment of isolated ascending aortic aneurysm by off-pump epiaortic wrapping is safe and durable. Interact Cardiovasc Thorac Surg. 2016;23:286–91.PubMedCrossRefGoogle Scholar
  130. 130.
    Golesworthy T, Lamperth M, Mohiaddin R, et al. The tailor of Gloucester: a jacket for the Marfan’s aorta. Lancet. 2004;364:1582.CrossRefPubMedGoogle Scholar
  131. 131.
    Treasure T, Takkenberg JJ, Golesworthy T, et al. Personalised external aortic root support (PEARS) in Marfan syndrome: analysis of 1-9 year outcomes by intention-to-treat in a cohort of the first 30 consecutive patients to receive a novel tissue and valve-conserving procedure, compared with the published results of aortic root replacement. Heart. 2014;100:969–75.PubMedPubMedCentralCrossRefGoogle Scholar
  132. 132.
    Treasure T, Petrou M, Rosendahl U, et al. Personalized external aortic root support: a review of the current status. Eur J Cardiothorac Surg. 2016;50:400–4.PubMedCrossRefGoogle Scholar
  133. 133.
    Hess PJ, Jr., Klodell CT, Beaver TM et al. (2005) The Florida sleeve: a new technique for aortic root remodeling with preservation of the aortic valve and sinuses. Ann Thorac Surg 80:748–750.PubMedCrossRefGoogle Scholar
  134. 134.
    Kunzelman KS, Grande KJ, David TE, et al. Aortic root and valve relationships. Impact on surgical repair. J Thorac Cardiovasc Surg. 1994;107:162–70.PubMedGoogle Scholar
  135. 135.
    Heo W, Min HK, Kang do K, et al. A modified root reinforcement technique for acute aortic dissection with a weakened aortic root: a modified Florida sleeve technique and two cases report. J Cardiothorac Surg. 2013;8:203.PubMedPubMedCentralCrossRefGoogle Scholar
  136. 136.
    Hess P, Caranasos T, Siegal S, et al. Valve-sparing repair of aortic root aneurysms: an update on the Florida sleeve. Heart Surg Forum. 2014;17:E10–2.PubMedCrossRefGoogle Scholar
  137. 137.
    Hess PJ Jr, Harman PK, Klodell CT, et al. Early outcomes using the Florida sleeve repair for correction of aortic insufficiency due to root aneurysms. Ann Thorac Surg. 2009;87:1161–8. discussion 1168–9PubMedCrossRefGoogle Scholar
  138. 138.
    Pethig K, Schafers HJ, Borst HG. Functional results after aortic valve repair in aortic root ectasia. J Heart Valve Dis. 1996;5:247–50.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardiac Surgery, Charles University, Faculty of Medicine in Hradec KrálovéUniversity Hospital Hradec KrálovéHradec KrálovéCzech Republic

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