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Left Ventricular Outflow Tract Reconstructions

  • Chapter
Cardiac Reconstructions with Allograft Valves

Abstract

The developing role for allograft transplants is reviewed in chapters 1 and 2. The major controversy resides in the issue of durability. The hemodynamic performance of a properly placed allograft is clearly superior to stented xenograft or mechanical valve and the advantages concerning resistance to infection and the avoidance of anticoagulation are becoming more evident and attractive. Good long-term performance is dependent on an excellent technical surgical result. The surgeon must view the use of allograft tissue as a tool for the reconstruction of the left ventricular outflow tract rather than as an implant of a device. This requires mastering both the analysis of the outflow tract as well as multiple methods for its reconstruction.

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References

  1. Karp RB: The future of homografts. J Cardiac Surg 2(suppl):2–5–308, 1987.

    Google Scholar 

  2. Barratt-Boyes BG: The timing of operation in valvular insufficiency. J Cardiac Surg 2: 435–452, 1987.

    Article  CAS  Google Scholar 

  3. Barratt-Boyes BG, Roche AHG, Subramanyan R, et al: Long-term follow-up of patients with the antibiotic-sterilized aortic homograft valve inserted free-hand in the aortic position. Circulation 75: 768–777, 1987.

    Article  PubMed  CAS  Google Scholar 

  4. Yankah CA: State of the art. Presented at the First Workshop on Homologous and Autologous Heart Valves. Chicago: Deborah Heart and Lung Center, 5 April 1987.

    Google Scholar 

  5. Imamura I, Tomizawa Y, Hashimoto A, et al: A comparative analysis of left ventriculography and root aortography for estimating aortic annulus size. J Thorac Cardiovasc Surg 93: 592–596, 1987.

    PubMed  CAS  Google Scholar 

  6. Bonchek LI, Burlingame MV, Vazales BE: Accuracy of sizers for aortic valve prostheses. J Thorac Cardiovasc Surg 94: 632–634, 1987.

    PubMed  CAS  Google Scholar 

  7. Barratt-Boyes BG, Roche AHG: Review of aortic valve homografts over a six and one-half year period. Ann Surg 170: 483–487, 1969.

    Article  PubMed  CAS  Google Scholar 

  8. Barratt-Boyes BG: Homograft aortic valve replacement in aortic incompetence and stenosis. Thorax 19: 131–150, 1964.

    Article  PubMed  CAS  Google Scholar 

  9. Karp RB: The use of freehand unstented aortic valve allografts for replacement of the aortic valve. J Cardiac Surg 1: 23–32, 1986.

    Article  CAS  Google Scholar 

  10. Barratt-Boyes BG: A method for preparing and inserting homograft aortic valve. Br J Surg 52: 847–856, 1965.

    Article  PubMed  CAS  Google Scholar 

  11. Barratt-Boyes BG: A method for preparing and inserting homograft aortic valve. Br J Surg 52: 847–856, 1965.

    Article  PubMed  CAS  Google Scholar 

  12. Ross DN: Application of homografts in clinical surgery. J Cardiac Surg 1: 175–183, 1987.

    Google Scholar 

  13. Doty DB: Replacement of the aortic valve with cyropreserved aortic valve allograft: considerations and techniques in children. J Cardiac Surg l(suppl): 129–136, 1981.

    Google Scholar 

  14. Doty DB: Aortic homograft technique. In: Cardiac Surgery. Chicago: Yearbook, 1986, pp. 12–15.

    Google Scholar 

  15. Clarke DR: Extended aortic root replacement for treatment of left ventricular outflow tract obstruction. J Cardiac Surg l(suppl): 121–128, 1987.

    Google Scholar 

  16. McKowen RL, Campbell DN, Woelfel GF, et al: Extended aortic root replacement with aortic allografts. J Thorac Cardiovasc Surg 93: 366–374, 1987.

    PubMed  CAS  Google Scholar 

  17. Ross DN, Yacoub MH: Homograft replacement of the aortic valve—a critical review. Prog Cardiovasc Dis 11: 275–293, 1969.

    Article  PubMed  CAS  Google Scholar 

  18. Moreno-Cabrol CE, Miller C, Shumway NE: A simple technique for aortic valve replacement using freehand allografts. J Cardiac Surg 3: 69–76, 1988.

    Article  Google Scholar 

  19. Frater RWM: Aortic valve insufficiency due to aortic dilatation: correction by sinus rim adjustment. Circulation 74 (suppl I): I136–I142, 1986.

    Google Scholar 

  20. Bailey WW: A modified freehand technique for homograft aortic valve replacement. J Cardiac Surg 2: 193–197, 1987.

    CAS  Google Scholar 

  21. Teoh KH, Fulop JC, Weisel RD, et al: Aortic valve replacement with a small prosthesis. Circulation 76(suppl III):III123–III131, 1987.

    Google Scholar 

  22. Kirklin JW, Barratt-Boyes BG: Cardiac Surgery. New York: Wiley, 1986, pp. 416–418.

    Google Scholar 

  23. Manouguian S, Seybold-Epting W: Patch en-largement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet. J Thorac Cardiovasc Surg 78: 402–412, 1979.

    PubMed  CAS  Google Scholar 

  24. Nicks R, Cartmill T, Bernstein L: Hypoplasia of the aortic root—the problem of aortic valve replacement. Thorax 25: 339–345, 1970.

    Article  PubMed  CAS  Google Scholar 

  25. McAlpine WA: Heart and Coronary Arteries. New York: Springer-Verlag, 1975, p. 22.

    Google Scholar 

  26. Virdi IS, Monro JL, Ross JK: Eleven year experience of aortic valve replacement with antibiotic sterilized homograft valves in Southampton. Thorac Cardiovasc Surg 34: 277–282, 1986.

    Article  PubMed  CAS  Google Scholar 

  27. Nunez L, Aguado MG, Pinto AG, Larren JL: Enlargement of the aortic annulus by resecting the commissure between the left and non-coronary cusps. Texas Heart Inst J 10: 301–307, 1983.

    CAS  Google Scholar 

  28. McAlpine WA: Heart and Coronary Arteries. New York: Springer-Verlag, 1975, p. 24.

    Google Scholar 

  29. Summerville J, Ross D: Homograft replacement of aortic root with reimplantation of coronary arteries—results after one-five years. Br Heart J 47: 473–482, 1982.

    Article  Google Scholar 

  30. Gula G, Ahmed M, Thompson R, et al: Combined homograft replacement of the aortic valve and aortic root with reimplantation of the coronary arteries. Circulation 53/54(suppl II):II150, 1976.

    Google Scholar 

  31. Thompson R, Yacoub M, Ahmed M, et al: The use of “fresh” unstented homograft valves for replacement of the aortic valve. J Thorac Cardiovasc Surg 79: 896–903, 1980.

    Google Scholar 

  32. Okita Y, Franciosi G, Matsuki O, Robles A, Ross DN. Early and late results of aortic root replacement with antibiotic-sterilized aortic homograft. J. Thorac Cardiovasc Surg 95: 696–704, 1988.

    PubMed  CAS  Google Scholar 

  33. Ross D: Application of homografts in clinical surgery. J Cardiac Surg l(suppl): 175–181, 1987.

    Google Scholar 

  34. Dziatkowiak A, Pfitzner R, Andres J, et al: Modified techniques for subcoronary insertion of allografts in Yonkah AC, Hertzer R, Miller DC, et al (eds) Cardiac Valve Allografts 1962–1987. New York: Springer Verlag, 1988. pp 141–147.

    Google Scholar 

  35. Morrow AG: Hypertrophic subaortic stenosis: op-erative methods utilized to relieve left ventricular outflow obstruction. J Thorac Cardiovasc Surg 76: 423–430, 1978.

    PubMed  CAS  Google Scholar 

  36. Konno S, Imai Y, Lida Y, et al: A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring. J Thorac Cardiovasc Surg 70: 909–917, 1975.

    PubMed  CAS  Google Scholar 

  37. Rastan H, Koncz J: Aortoventriculoplasty: a new technique for the treatment of left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 71: 920–927, 1976.

    PubMed  CAS  Google Scholar 

  38. Rastan H, Abu Aishah N, Rastan D, et al: Results of aortoventriculoplasty in twenty-one consecutive patients with left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 75: 659–669, 1978.

    PubMed  CAS  Google Scholar 

  39. Somerville J, Ross D: Homograft replacement of aortic root with reimplantation of coronary arteries. Br Heart J 47: 473–182, 1982.

    Article  PubMed  CAS  Google Scholar 

  40. Misbach GA, Turley K, Ullyot DJ, Ebert PA: Left ventricular outflow enlargement by the Konno procedure. J Thorac Cardiovasc Surg 94: 696–703, 1982.

    Google Scholar 

  41. Kirklin JW, Barratt-Boyes BG: Modified Konno operation. In: Cardiac Surgery. New York: Wiley, 1986, pp. 996–998.

    Google Scholar 

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Authors
  1. Richard A. Hopkins
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© 1989 Springer-Verlag New York Inc.

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Hopkins, R.A. (1989). Left Ventricular Outflow Tract Reconstructions. In: Cardiac Reconstructions with Allograft Valves. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3568-2_6

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  • DOI: https://doi.org/10.1007/978-1-4612-3568-2_6

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8159-7

  • Online ISBN: 978-1-4612-3568-2

  • eBook Packages: Springer Book Archive

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