Aortic Regurgitation

Foreword
Terminology and list of abbreviations

Intermezzo I: Leonardo

P. Zacek

Chapter 1 Clinical and surgical anatomy of the aortic root

H. Muresian

Chapter 2 Living anatomy of the aortic root

R. H. Anderson, D. E. Spicer, S. Mori

Intermezzo II: Eponyms related to aortic regurgitation

P. Zacek

Chapter 3?Functional anatomy of the aortic valve and dynamics of the aortic root

E. Lansac, I. Di Centa

3.1? Experimental data on dynamic anatomy of the aortic root

3.2?Echocardiographic anatomy of the normal aortic root

3.3?Dynamic approach to aortic valve reconstruction

Chapter 4?Congenital anomalies of the aortic valve

J. Vojacek, P.

Zacek, J. Dominik, T. Holubec

4.1?Bicuspid aortic valve

4.1.1?Morphology

4.1.2?Natural history

4.1.3?Stenosis of BAV

4.1.4?Regurgitation of BAV

4.1.5?Endocarditis of BAV

4.1.6?Dilation of the ascending aorta

4.1.7?Treatment

4.2? Unicuspid aortic valve

4.2.1? Morphology

4.2.2? Natural history

4.2.3? Treatment

4.3? Quadricuspid aortic valve

4.3.1? Natural history

4.3.2?Treatment

Intermezzo III: Dominic John Corrigan (1802-1880)

P. Zacek

Chapter 5 Aortic regurgitation: from diagnosis towards indication

M. Brtko

5.1?Incidence, prevalence and etiology of aortic regurgitation

5.2?Pathophysiology of aortic regurgitation and natural history

5.3?Clinical manifestation

5.4?Diagnostics

5.5?Quantification of aortic regurgitation

5.6?Indication for operation



5.7?Medical treatment and follow-up of asymptomatic patients

5.8?Acute aortic regurgitation

Chapter 6?Connective tissue disorders

M.-C. Morgant, I. El-Hamamsy

6.1? Vascular wall connective tissue

6.1.1?Fibrillin

6.1.2?Collagen

6.1.3?Elastin

6.2?Vascular smooth muscle cells (VSMC)

6.3?Thoracic aortic aneurysms (TAA)

6.3.1?Syndromic diseases

6.3.2?Non-syndromic thoracic aortic aneurysms

Chapter 7?Echocardiography of the

aortic valve

M. Tuna

7.1?Assessment of the valve morphology

7.2?Cusp analysis, bicuspid and unicuspid aortic valve

7.3?Degenerative, postrheumatic and postinfective aortic valve lesions

7.4?3D echocardiography of the aortic valve

7.5?Dilation of the aortic root and the ascending aorta

7.6?Doppler examination of the aortic valve

7.7?Preoperative and postoperative echocardiographic assessment of the aortic valve

Intermezzo IV: Alfred de Musset (1810-1857)

P. Zacek

Chapter 8 ?Computed tomography and magnetic resonance of the aortic valve and ascending aorta

M. Solar, Z. Belobradek

8.1?Technical aspects of CT and MR imaging

8.1.1?History of cardiac CT imaging



8.1.2?Cardiac CT parameters in comparison with other imaging modalities

8.1.3?Iodine contrast agents

8.1.4?CT imaging artifacts

8.1.5?Current possibilities of cardiac CT

8.1.6?Magnetic resonance imaging

8.1.7?Technical possibilities of MR in aortic root imaging

8.2?Role of CT and MR in specific diagnostics of aortic regurgitation and aortic disease

8.2.1?Quantification of aortic regurgitation

8.2.2?Assessment of aortic valve and root morphology

8.2.3?Assessment of left ventricular morphology and function...208

Chapter?9 Therapy

9.1?Aortic valve replacement

J. Dominik, P. Zacek, J. Vojacek

9.1.1?Historical development and types of aorti

c valve replacement devices

9.1.2?Persistent problems after aortic valve replacement

9.2?Transcatheter aortic valve implantation (TAVI)

M. Brtko

9.3?Valve allograft in aortic valve surgery

J. Spatenka, J. Burkert

9.3.1?Definition

9.3.2?History

9.3.3?Processing of allogeneic valve grafts

9.3.4?Surgical technique

9.3.5?Indication for use of valve allografts

9.3.6?Results

9.4?Ross procedure

I. El-Hamamsy

9.4.1?Historical overview

9.4.2?Concept

9.4.3?Results

9.4.4?Surgical principles and factors influencing technical success

9.5?Bentall procedure

J. Dominik, P. Zacek, J. Vojacek

9.5.1?Historical overview of Bentall procedure modifications

9.5.2?Results

9.5.3?Bentall procedure or a valve sparing procedure?

9.6?Development of conservative surgical treatment of aortic regurgitation

P. Zacek, J. Vojacek, J. Dominik

9.7?Valve preserving surgery in aortic regurgitation

J. Vojacek, P. Zacek, J. Dominik

9.7.1?Surgical correction of sinotubular junction dilation

9.7.2?Surgical correction of annular dilation

9.7.3?Surgical interventions on the aortic leaflets

9.7.4?Procedures on the aortic root and ascending aorta

9.7.5?Perioperative assessment of aortic valve function

9.7.6?Results of aortic valve sparing procedures

9.7.7?'Conservative' surgical procedures

Intermezzo V: Lincoln sign

P. Zacek



Chapter 10?Longterm results of aortic valve replacement and repair

B. Arabkhani, J. J. M. Takkenberg

10.1?Indication for operation for aortic regurgitation

10.2?Surgical treatment options

10.2.1?Mechanical valve prostheses

10.2.2?Biological valve prostheses

10.2.3?Aortic valve repair and valve sparing procedures on the aortic root

10.3?Results after aortic valve replacement and aortic valve repair

10.3.1? Results after mechanical aortic valve replacement and Bentall procedure

10.3.2? Results after aortic valve replacement with a stented bioprosthesis

10.3.3? Results after aortic valve replacement with a stentless bioprosthesis

10.3.4? Results after aortic v

alve and root replacement with an allograft

10.3.5? Results of the Ross procedure

10.3.6? Results of aortic valve-sparing root procedures

10.3.7?Results of aortic valve repair

10.4?Quality of life after aortic valve surgery

10.5?Choice of optimal strategy for an individual patient with aortic regurgitation

Intermezzo VI:

Taliesin Golesworthy, the inventor of treatment of his own disease

P. Zacek

Chapter 11?Recommendations for out-patient care after aortic valve surgery

M. Brtko

11.1?Out-patient follow-up

11.2?Antithrombotic treatment after aortic valve surgery

11.3?Infective endocarditis prophylaxis

Index

Summary

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• Cirurgia cardiotorácica
• Medicina cardiovascular

aortic regurgitation;aortic valve morphology;diagnostic imaging;surgical treatment;aortic valve repair;history of surgical treatment