Experience in prosthetics of the root and ascending aorta according to the method of David T.E. Retaining your own tricuspid and bicuspid aortic valves and the frequency of plasty of their valves
Operations of valve-preserving prosthetics for aortic root aneurysms relieve the patient from the mandatory intake of blood-reducing drugs and potential complications from their use, as well as from prosthetic-related complications. With the preservation of the leaflets, in more than 30 % of cases, the preservation of the aortic valve is possible. For the period 01/01/2019-09/01/2022, 33 aortic root replacement surgeries were performed at the CWC of St. Joasaph's Regional Clinical Hospital. In 19 (57.6 %) cases with degenerative lesions of the leaflets, aortic valve replacement was performed: according to the method of Bentall H., De Bono A. in 11 (33.3 %) cases, with implantation of the conduit inside the preserved aneurysmal sac according to the method of Kouchoukos N.T. 8 (24.2 %). Of the 33 surgeries, 14 (42.4 %) were performed using the David T.E. valve-preserving technique. Patients: 13 men, 1 woman, age 23-68 (55.5 ± 12.4) years. In 13 cases, the operation was performed on the tricuspid aortic valve and in 1 case, on the bicuspid valve. One operation was performed for chronic dissecting aneurysm of the ascending aorta type 2 according to M. DeBakey. There were no aortas in the general group: in-hospital mortality, bleeding, A-B blockade. All patients were discharged within the standard postoperative period. There was one successful reoperation in the valve-preserving ascending group. Tranthoracic echocardiography at discharge assessed regurgitation on the preserved aortic valve at grade 1-2. Our results of application of operation David T.E. correspond to the global statistics of the treatment of this pathology. In the long-term period, patients lead a normal life, without restrictions on drug therapy. This operation has shown good results and will therefore be continued.
Sazonenkov M.A., Ismatov Kh.H., Tatarintsev A.M., Moskalev A.S. 2022. The First Experience of Prosthetics of the Root and Ascending Aorta in Department of Cardiac Surgery of the St. Ioasaf Belgorod Regional Clinic According to the Method of David T.E. Рreservation of its Own Tricuspid and Bicuspid Aortic Valves and Frequency of Plasty of the Leaflets. Challenges in Modern Medicine, 44 (4): 374–387 (in Russian). DOI: 10.52575/2687-0940-2022-45-4-374-387
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Bokeriya L.A., Skopin I.I., Sazonenkov M.A. 2008. K voprosu ob anatomii stvorok aortal'nogo klapana [On the question of the anatomy of the aortic valve cusps]. Byulleten' NTsSSKh im. A.N. Bakuleva RAMN. 1: 5–10.
Akinseye O.A., Pathak A., Ibebuogu U.N. 2018. Aortic Valve Regurgitation: A Comprehensive Review. Curr. Probl. Cardiol. 43 (8): 315–334. doi: 10.1016/j.cpcardiol.2017.10.004.
Beckmann E., Martens A., Krüger H., Korte W., Kaufeld T., Stettinger A., Haverich A., Shrestha M.L. 2021. Aortic valve-sparing root replacement with Tirone E. David's reimplantation technique: single-centre 25-year experience. Eur. J. Cardiothorac. Surg. Sep 11; 60 (3): 642–648. doi: 10.1093/ejcts/ezab136
Bentall H., De Bono A. 1968. A technique for complete replacement of the ascending aorta. Thorax. 23: 338–339. doi:10.1136/thx.23.4.338
David T.E. Feindel C.M. 1992. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J. Thorac. Cardiovasc. Surg. 103: 617–621.
Fiorucci B., Banafsche R., Jerkku T., Pichlmaier M., Kölbel T., Rantner B., Tsilimparis N. 2019. Thoracic Aortic Aneurysms – Diagnosis and Treatment Strategies. Dtsch. Med. Wochenschr. 144 (3): 146–151. doi: 10.1055/a-0648-0207
Gregory S.H., Yalamuri S.M., Bishawi M., Swaminathan M. 2018. The Perioperative Management of Ascending Aortic Dissection. Anesth. Analg. Dec; 127 (6): 1302–1313. doi: 10.1213/ANE.0000000000003747
Gudbjartsson T., Ahlsson A., Geirsson A., Gunn J., Hjortdal V., Jeppsson A., Mennander A., Zindovic I., Olsson C. 2020. Acute type A aortic dissection – a review. Scand. Cardiovasc. J. 54 (1): 1–13. doi: 10.1080/14017431.2019.1660401
Guo M.H., Appoo J.J., Saczkowski R., Smith H.N., Ouzounian M., Gregory A.J., Herget E.J., Boodhwani M. 2018. Association of Mortality and Acute Aortic Events With Ascending Aortic Aneurysm: A Systematic Review and Meta-analysis. JAMA Netw. Open. Aug 3; 1 (4): e181281. doi: 10.1001/jamanetworkopen.2018.1281
Katsi V., Magkas N., Antonopoulos A., Trantalis G., Toutouzas K., Tousoulis D. 2021. Aortic valve: аnatomy and structure and the role of vasculature in the degenerative process. Acta. Cardiol. 76 (4): 335–348. doi: 10.1080/00015385.2020.1746053
Khelil N., Sleilaty G., Palladino M., Fouda M., Escande R., Debauchez M., Di Centa I., Lansac E. 2015. Surgical Anatomy of the Aortic Annulus: Landmarks for External Annuloplasty in Aortic Valve Repair. Ann. Thorac. Surg. 99: 1220–7. doi: 10.1016/j.athoracsur.2014.12.034.
Kouchoukos N.T., Karp R.B., Lell W.A. 1977. Replacement of the ascending aorta and aortic valve with a composite graft: results in 25 patients. Ann. Thorac. Surg. 24: 140–148. doi: 10.1016/s0003-4975(10)63723-x
Mazine A., David T.E., Lafreniere-Roula M., Feindel C.M., Ouzounian M. 2021. Early outcomes of the Bentall procedure after previous cardiac surgery. J. Thorac. Cardiovasc. Surg. 162 (4): 1063–1071. doi: 10.1016/j.jtcvs.2019.12.134
Saeyeldin A.A., Velasquez C.A., Mahmood S.U.B., Brownstein A.J., Zafar M.A., Ziganshin B.A., Elefteriades J.A. 2019. Thoracic aortic aneurysm: unlocking the «silent killer» secrets. Gen. Thorac. Cardiovasc. Surg. Jan; 67 (1): 1–11. doi: 10.1007/s11748-017-0874-x. Epub 2017 Dec 4
Salem R., Zierer A., Karimian-Tabrizi A., Miskovic A., Moritz A., Risteski P., Monsefi N. 2020. Aortic Valve Repair for Aortic Insufficiency or Dilatation: Technical Evolution and Long-term Outcomes. Ann. Thorac. Surg. 110 (6): 1967–1973. doi: 10.1016/j.athoracsur.2020.03.105
Uchida K., Karube N., Kasama K., Minami T., Yasuda S., Goda M., Suzuki S., Imoto K., Masuda M. 2018. Early reperfusion strategy improves the outcomes of surgery for type A acute aortic dissection with malperfusion. J. Thorac. Cardiovasc. Surg. 156 (2): 483–489. doi: 10.1016/j.jtcvs.2018.02.007
Weininger G., Mori M., Yousef S., Hur D.J., Assi R., Geirsson A., Vallabhajosyula P. 2022. Growth rate of ascending thoracic aortic aneurysms in a non-referral-based population. J. Cardiothorac. Surg. Feb 2; 17 (1): 14. doi: 10.1186/s13019-022-01761-6
Yacoub M.H., Aguib H., Gamrah M.A., Shehata N., Nagy M., Donia M., Aguib Y., Saad H., Romeih S., Torii R., Afifi A., Lee S.L. 2018. Aortic root dynamism, geometry, and function after the remodeling operation: Clinical relevance. J. Thorac. Cardiovasc. Surg. 951–962.e2. doi: 10.1016/j.jtcvs.2018.03.157