[HSF] Bicuspid aortic valve and dilated ascending aorta

[Ben Bidstrup]

I have used this a few times as well. The shape of the proximal graft 
allows it to sit very nicely in the anatomic position of the root. 
The buttonns for the cornaries sit nicely with less tension IMHO.
For David procedures, it may have some long term advantages as the 
shape of the sinuses is better than when you do a bit of cobbling. 
Have a look at this site:

http://mmcts.ctsnetjournals.org/cgi/content/full/2007/0102/mmcts.2006.001958

>The company Vascutek makes a graft called Gelweave Valsalve graft - follow
>the hyperlink   http://www.vascutek.com/usa/index1.htm
>
>I have used the graft on a few occasions and it appears to sew well and
>the principal sounds good.  The cost of the graft is slightly more than
>the usual Hemashield graft, and it sews well.
>
>Importantly they do make arch grafts that don't leak.
>
>Tim Sloan
>
>
>  Dr. Damle, could you explain Valsava graft?
>>
>>
>>
>>  ----- Original Message -----
>>  From: "Ajit Damle" <damle at cableone.net>
>>  To: <OpenHeart-L at lists.hsforum.com>
>>  Sent: Tuesday, April 24, 2007 8:54 AM
>>  Subject: RE: [HSF] Bicuspid aortic valve and dilated ascending aorta
>>
>>
>>  I have had similar cases recently. I would recommend strongly replacing
>>  the
>>  aortic root, if you can do it with low morbidity and mortality.
>>
>>  If you decide to re-implant the coronary ostia, I strongly recommend the
>>  Valsalva graft.  I also liberally use a topical sealant, CoSeal. I have
>>  gotten away in several cases without any blood/blood product transfusion.
>>
>>  Good l;uck!
>>
>>  Ajit Damle
>>
>>
>>
>>
>>  -----Original Message-----
>>  From: openheart-l-bounces at lists.hsforum.com
>>  [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Zhandong Zhou
>>  Sent: Monday, April 23, 2007 5:22 PM
>>  To: OpenHeart-L at lists.hsforum.com
>>  Subject: [HSF] Bicuspid aortic valve and dilated ascending aorta
>>
>>  To Forum,
>>
>>  I have a 51 year old patient with bicuspid aortic valve, severe AR with
>>  4.0
>>  cm root. choices between mini-invasive AVR (through 2nd intercostal space,
>>  2.5 inch incision) vs full sternotomy with Bentall. I personally prefer
>>  mini
>>
>>  AVR then see what happens in the future.
>>
>>  Any suggestions?
>>
>>  Z Zhou
>>
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon