| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2003;125:773-778
© 2003 The American Association for Thoracic Surgery
Editorials |
From the Department of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, Calif.
Received for publication Sept 7, 2002. Revisions requested Sept 17, 2002; revisions received Sept 23, 2002. Accepted for publication Oct 3, 2002. Address for reprints: D. Craig Miller, MD, Department of Cardiovascular Surgery, Stanford University School of Medicine, Falk Cardiovascular Research Center CV 243, 300 Pasteur Dr, Stanford, CA 94305-5407 (E-mail: dcm@stanford.edu).
| The first 300 words of the full text of this article appear below. |
 |
Introduction |
|---|
Your Editor solicited commentary for this provocative article,
1 not so much to enter the fray concerning which method of valve-sparing aortic root replacement—Yacoub remodeling versus David reimplantation—is best for patients with the Marfan syndrome (MFS), but to clarify for the readership the key differences between the two procedures and how these operations have evolved. I will also emphasize six points raised by the article.
Historically, conventional cardiovascular surgical treatment for patients with the MFS who have aneurysm or dissection involving the ascending aorta has been replacement of the entire aortic root and valve with a composite valve graft (CVG) and reimplantation of the coronary artery ostia. A CVG incorporating a mechanical valve is usually used because most of these patients are young, can safely tolerate anticoagulation with warfarin, and do not wish to accept the risk of another operation. Over the past 30 years, CVG has become a low risk operation and a very durable one for patients with the MFS. 2-4 On the other hand, some patients have medical contraindications that make indefinite anticoagulation inadvisable, others are not medically compliant enough for anticoagulation to be safe, some individuals have lifestyles that make anticoagulation hazardous, others do not have secure long-term access to health insurance or continuing medical care, some have an aversion to anticoagulation, and the older patients do not need a new valve that will last for many decades. In these relatively infrequent circumstances, the aortic root and valve can be replaced with an allograft aortic root, a stentless porcine xenograft aortic root, or a Dacron tube graft with a stented bioprosthesis sewn into it. 4 A Ross-Shumway procedure is contraindicated because of the aneurysmal disease and underlying connective tissue disorder. The durability of all these various tissue valve alternatives, however, is limited.
Related Article
J. Thorac. Cardiovasc. Surg. 2003 125: 789-796.
This article has been cited by other articles:
|
|
 |
|
  M. G. Keane and R. E. Pyeritz Medical Management of Marfan Syndrome Circulation, May 27, 2008; 117(21): 2802 - 2813. [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. David Aortic Valve Repair and Aortic Valve Sparing Operations Card. Surg. Adult, January 1, 2008; 3(2008): 935 - 948. [Full Text]
|
|
|
|
 |
|
 D. Maselli, R. De Paulis, R. Scaffa, L. Weltert, A. Bellisario, A. Salica, and A. Ricci Sinotubular Junction Size Affects Aortic Root Geometry and Aortic Valve Function in the Aortic Valve Reimplantation Procedure: An In Vitro Study Using the Valsalva Graft Ann. Thorac. Surg., October 1, 2007; 84(4): 1214 - 1218. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kallenbach, M. Karck, and A. Haverich Valve-sparing aortic root replacement: the inclusion (David) technique MMCTS, May 7, 2007; 2007(0507): 1917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Svensson, E. H. Blackstone, J. Feng, D. de Oliveira, A. M. Gillinov, M. Thamilarasan, R. A. Grimm, B. Griffin, D. Hammer, T. Williams, et al. Are Marfan Syndrome and Marfanoid Patients Distinguishable on Long-Term Follow-Up? Ann. Thorac. Surg., March 1, 2007; 83(3): 1067 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Miller Valve-Sparing Aortic Root Replacement: Current State of the Art and Where Are We Headed? Ann. Thorac. Surg., February 1, 2007; 83(2): S736 - S739. [Full Text] [PDF]
|
|
|
|
|
|
A. W. Erasmi, H.-H. Sievers, J.F. M. Bechtel, T. Hanke, U. Stierle, and M. Misfeld Remodeling or Reimplantation for Valve-Sparing Aortic Root Surgery? Ann. Thorac. Surg., February 1, 2007; 83(2): S752 - S756. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Beller, M. R. Labrosse, F. Robicsek, and M. J. Thubrikar Quantitative approach to aortic valve-sparing surgery Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 526 - 530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Pacini, F. Settepani, R. De Paulis, A. Loforte, S. Nardella, D. Ornaghi, R. Gallotti, L. Chiariello, and R. Di Bartolomeo Early results of valve-sparing reimplantation procedure using the Valsalva conduit: a multicenter study. Ann. Thorac. Surg., September 1, 2006; 82(3): 865 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Patel, J. A. Williams, C. J. Barreiro, B. T. Bethea, T. P. Fitton, H. C. Dietz, J. A.C. Lima, P. J. Spevak, V. L. Gott, L. A. Vricella, et al. Valve-Sparing Aortic Root Replacement: Early Experience With the De Paulis Valsalva Graft in 51 Patients Ann. Thorac. Surg., August 1, 2006; 82(2): 548 - 553. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. C. Hughes, M. Swaminathan, and W. G. Wolfe Reimplantation Technique (David Operation) for Multiple Sinus of Valsalva Aneurysms Ann. Thorac. Surg., August 1, 2006; 82(2): e14 - e16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. David, C. M. Feindel, G. D. Webb, J. M. Colman, S. Armstrong, and M. Maganti Long-term results of aortic valve-sparing operations for aortic root aneurysm. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 347 - 354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fries, T. Graeter, D. Aicher, H. Reul, C. Schmitz, M. Bohm, and H.-J. Schafers In vitro comparison of aortic valve movement after valve-preserving aortic replacement J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 32 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. LeMaire, S. A. Carter, I. V. Volguina, A. T. Laux, D. M. Milewicz, G. W. Borsato, C. K. Cheung, J. Bozinovski, J. M. Markesino, W. K. Vaughn, et al. Spectrum of Aortic Operations in 300 Patients With Confirmed or Suspected Marfan Syndrome Ann. Thorac. Surg., June 1, 2006; 81(6): 2063 - 2078. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. De Paulis, R. Scaffa, S. Forlani, and L. Chiariello The Valsalva graft in aortic valve repair and replacement MMCTS, November 29, 2005; 2005(1129): 992. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Vricella, J. A. Williams, W. J. Ravekes, K. W. Holmes, H. C. Dietz, V. L. Gott, and D. E. Cameron Early Experience With Valve-Sparing Aortic Root Replacement in Children Ann. Thorac. Surg., November 1, 2005; 80(5): 1622 - 1627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Albes, U. A. Stock, and M. Hartrumpf Restitution of the Aortic Valve: What is New, What is Proven, and What is Obsolete? Ann. Thorac. Surg., October 1, 2005; 80(4): 1540 - 1549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. P. Urbanski Valve-Sparing Aortic Root Repair With Patch Technique Ann. Thorac. Surg., September 1, 2005; 80(3): 839 - 843. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, M. Karck, D. Pak, R. Salcher, N. Khaladj, R. Leyh, C. Hagl, and A. Haverich Decade of Aortic Valve Sparing Reimplantation: Are We Pushing the Limits Too Far? Circulation, August 30, 2005; 112(9_suppl): I-253 - I-259. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Hess Jr, C. T. Klodell, T. M. Beaver, and T. D. Martin The Florida Sleeve: A New Technique for Aortic Root Remodeling With Preservation of the Aortic Valve and Sinuses Ann. Thorac. Surg., August 1, 2005; 80(2): 748 - 750. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Markl, M. T. Draney, D. C. Miller, J. M. Levin, E. E. Williamson, N. J. Pelc, D. H. Liang, and R. J. Herfkens Time-resolved three-dimensional magnetic resonance velocity mapping of aortic flow in healthy volunteers and patients after valve-sparing aortic root replacement J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 456 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Gleason New graft formulation and modification of the David reimplantation technique J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 601 - 603. [Full Text] [PDF]
|
|
|
|
|
|
E. Bernabeu, M. Castella, C. Barriuso, and J. Mulet Acute limb ischemia due to embolization of biological glue after repair of type A aortic dissection Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 329 - 331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Maselli, A. Montalto, G. Santise, G. Minardi, C. Manzara, and F. Musumeci A normogram to anticipate dimension of neo-sinuses of valsalva in valve-sparing aortic operations Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 831 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Y. Kim, N. Martin, E. C. Hsia, R. E. Pyeritz, and D. A. Albert Management of Aortic Disease in Marfan Syndrome: A Decision Analysis Arch Intern Med, April 11, 2005; 165(7): 749 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Milewicz, H. C. Dietz, and D. C. Miller Treatment of Aortic Disease in Patients With Marfan Syndrome Circulation, March 22, 2005; 111(11): e150 - e157. [Full Text] [PDF]
|
|
|
|
|
|
E. Lansac, I. Di Centa, S. Varnous, A. Rama, F. Jault, C. M.G. Duran, C. Acar, A. Pavie, and I. Gandjbakhch External Aortic Annuloplasty Ring for Valve-Sparing Procedures Ann. Thorac. Surg., January 1, 2005; 79(1): 356 - 358. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Demers and D. C. Miller Simple Modification of "T. David-V" Valve-Sparing Aortic Root Replacement to Create Graft Pseudosinuses Ann. Thorac. Surg., October 1, 2004; 78(4): 1479 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Zehr, T. A. Orszulak, C. J. Mullany, A. Matloobi, R. C. Daly, J. A. Dearani, T. M. Sundt III, F. J. Puga, G. K. Danielson, and H. V. Schaff Surgery for Aneurysms of the Aortic Root: A 30-Year Experience Circulation, September 14, 2004; 110(11): 1364 - 1371. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Langer, D. Aicher, A. Kissinger, O. Wendler, H. Lausberg, R. Fries, and H.-J. Schafers Aortic Valve Repair Using a Differentiated Surgical Strategy Circulation, September 14, 2004; 110(11_suppl_1): II-67 - II-73. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, T. Oelze, R. Salcher, C. Hagl, M. Karck, R. G. Leyh, and A. Haverich Evolving Strategies for Treatment of Acute Aortic Dissection Type A Circulation, September 14, 2004; 110(11_suppl_1): II-243 - II-249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, R.G. Leyh, R. Salcher, M. Karck, C. Hagl, and A. Haverich Acute aortic dissection versus aortic root aneurysm: comparison of indications for valve sparing aortic root reconstruction Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Furukawa, H. Ohteki, Z.-L. Cao, Y. Narita, Y. Okazaki, S. Ohtsubo, and T. Itoh Evaluation of native valve-sparing aortic root reconstruction with direct imaging-- reimplantation or remodeling? Ann. Thorac. Surg., May 1, 2004; 77(5): 1636 - 1641. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Karck, K. Kallenbach, C. Hagl, C. Rhein, R. Leyh, and A. Haverich Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 391 - 398. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Del Campo Aortic insufficiency in patients with Marfan syndrome: A surgical dilemma J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 303 - 304. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Hopkins Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 886 - 897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Carrel, P. Berdat, M. Pavlovic, S. Sukhanov, L. Englberger, and J.-P. Pfammatter Surgery of the dilated aortic root and ascending aorta in pediatric patients: techniques and results Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 249 - 254. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
