[HSF] Root Replacement with a Stentless Valve

[erdinç naseri]

What is pseudotrue Bentall( peudo and true are just the opposite of each other)
erdinc> Date: Sun, 24 Jun 2007 22:27:12 -0400> From: tdmartin2000 at aol.com> Subject: Re: [HSF] Root Replacement with a Stentless Valve> To: OpenHeart-L at lists.hsforum.com> CC: > > Prasanna> The last one I posted was a redo freestyle stentless valve and it was a ----, very difficult operation. Even after 7 yrs the freestyle had no calcification but the adhesions around the root were extreme and mobilization of the coronaries was near impossible. We ended up leaving them almost in place and doing a pseudo true Bental. Now the infection probably played a significant role, but still it was very difficult.> > Tom Martin> > > > In a message dated 06/24/07 21:21:31 Eastern Daylight Time, prasannasimha at gmail.com writes:> How easy/ difficult was the removal of the old root ? > Prasanna > Neal Kon wrote: > > Hi Hal, > > Sorry for the late reply, but I was just recently made aware of your > > post. As you know we do a lot of root replacement stentless aortic > > valves since I think the best way to implant a stentless valve is to use > > the full root technique. We have done just under 800 stentless root > > implants starting in 1992. We have only had to replace 6 of our own, 4 > > for svd-all in the early group- and two for endocarditis. I have also > > done some redo LV pseudoaneurysms done the first time elsewhere. We have > > lost 2 of our own redos and none of the outside redo referrals. The > > mortalities though have been a result of very sick elderly patients with > > multiple co-morbidities also requiring a long operation. The redo root > > in a healthier population, ie our homograft population carries an > > exceedingly low mortality, primarily because we catch them early and > > they are younger patients without many co-morbidities. > > Even though we do a lot of root replacements, I agree with not just > > automatically removing the normal aortic root when one can easily > > implant one of the newer generation stented valves and not end up with > > mismatch (especially in a patient with depressed LV function). Our > > indications for stentless root replacement are: > > 1. An abnormal aortic root with aortic valve disease when a tissue valve > > is chosen > > 2. Elderly patients with heavily calcified sinuses--it is much easier to > > work with excess synthetic material than heavily diseased native tissues > > 3. Prevent patient prosthesis mismatch, or whatever you like to call > > putting too small a valve in is, especially with depressed LV function. > > (A stentless root replacement is more effective hemodynamically and > > easier for me than root enlargement.) > > 4. Patients who have had a previous borderline size stented valve that > > needs to be redone. > > 5. Endocarditis when you do not have the optimal size homograft > > available. > > > > Sorry for the long post. Hope it is a little helpful. > > Neal Kon > > > > > > > > > > _______________________________________________ > > OpenHeart-L mailing list > > > > Send postings to: > > OpenHeart-L at lists.hsforum.com > > > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > > http://mmp.cjp.com/mailman/listinfo/openheart-l > > > > All messages transmitted by the OpenHeart-L are subject to the policies and > > disclaimers posted at: > > http://www.hsforum.com/listdisclaim > > ----------------------------------------- > > > > > > > > _______________________________________________ > OpenHeart-L mailing list > > Send postings to: > OpenHeart-L at lists.hsforum.com > > To UNSUBSCRIBE, to CHANGE email address, or to view archives: > http://mmp.cjp.com/mailman/listinfo/openheart-l > > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at: > http://www.hsforum.com/listdisclaim > ----------------------------------------- > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------