Aortic regurgitation today is the third most common valvular pathology in industrial countries, either isolated to the valve or in conjunction with aortic disease. With changing demographics it can be expected to increase in prevalence in the next years. The past years have brought about dynamic changes in surgical options, imaging techniques and also patient expectations. A group of internationally highly renowned authors from different specialties have made a joint effort to provide a state-of-the-art overview of all aspects of the disease. Anatomy, pathology, cardiological aspects and current guidelines are presented by leaders in their fields. Surgical techniques and their long-term results are summarised by an international team of individuals with a strong track record in their respective areas. The topics are presented precisely, comprehensively and can be a reference to all health care professionals seeking information on the latest developments.
Inhalt
1. Anatomy (Basso C, Lansac E, Rizzo S, Thiene G) 151.1. The pathology of aortic incompetence 151.1.1. Introduction and historical notes 151.1.2. Aortic root anatomy 151.1.3. Embryology of the aortic valve 171.1.4. The aorta 181.1.5. The pathology of the aortic root and aortic incompetence 181.1.6. Inflammatory disease of the aortic valve 181.1.6.1. Rheumatic valve disease 181.1.6.2. Infective endocarditis 201.1.6.3. Degenerative pathology of the aortic root 201.1.6.4. Aortic dissection 221.1.6.5. Rare causes of native aortic valve incompetence 231.1.6.6. Aetiology of aortic regurgitation in surgical pathology experience 231.1.6.7. Regurgitation in prosthetic aortic valves 231.2. Functional anatomy of the aortic valve and dynamics of aortic root 271.2.1. Echocardiographic anatomy of the normal aortic root 282. Aortic regurgitation Epidemiology, natural history, guidelines (Iung B, Vahanian A) 322.1. Epidemiology and aetiologies 322.1.1. Degenerative aortic regurgitation 322.1.2. Bicuspid aortic valve disease 332.1.3. Rheumatic heart disease 332.1.4. Infective endocarditis 342.1.5. Inflammatory aortic diseases 342.1.6. Aortic dissection 342.1.7. Other causes of aortic regurgitation 342.2. Natural history 342.2.1. Severity of aortic regurgitation 342.2.2. Consequences of aortic regurgitation on the left ventricle 342.2.3. Enlargement of ascending aorta 352.3. Current guidelines 352.3.1. Diagnostic workup 372.3.2. Indications for the correction of aortic regugitation 372.3.3. Indications for surgery of the ascending aorta 382.3.4. Medical therapy 383. Aortic regurgitation: Role of echocardiography (Vanoverschelde J-L) 423.1. Echocardiographic examination of the aortic valve and root 423.2. Echocardiographic assessment of aortic regurgitation severity 433.2.1. Colour flow Doppler 433.2.2. Vena contracta width 443.2.3. The flow convergence method 443.2.4. Pulsed Doppler volumetric method 453.2.5. Diastolic flow reversal in the descending aorta 453.2.6. Continuous-wave Doppler of the aortic regurgitation jet 463.3. Echocardiographic assessment of the haemodynamic consequences of aortic regurgitation 463.4. Echocardiographic assessment of the mechanisms of aortic regurgitation and prediction of reparability 463.4.1. Functional anatomy of aortic regurgitation 463.4.2. Assessment of aortic valve reparability 483.5. Echocardiographic assessment of the results of aortic regurgitation repair 494. Aortic regurgitation: Medical treatment (Vanoverschelde J-L) 515. Mechanical valve/composite replacement for aortic regurgitation or aneurysm (Ikonomidis JS, Theruvath TP) 535.1. History of mechanical heart valves 535.2. Aortic regurgitation and aneurysm 545.3. Surgical technique 545.4. Results of mechanical valve graft replacements 576. Aortic regurgitation with and without aneurysmal disease (Deb S, Fremes SE, Tsubota H) 636.1. History and Background of Biological Valves 636.2. Mechanical versus Bioprosthetic Valve Studies 636.3. Stented vs Stentless Bioprosthetic Valves 646.4. Technique of the Stented Bioprosthetic Aortic Valve Replacement 656.5. Results of aortic valve replacement 676.6. Aneurysmal Ascending Aorta and Aortic Regurgitation 676.7. Composite Valve-Graft Technique 686.8. Results of Composite aortic valve replacement 707. Ross operation (Stelzer P, Varghese R) 747.1. Indications in aortic regurgitation 747.2. Technique for Ross root replacement in treatment of aortic regurgitation 757.3. Addressing a concomitantly dilated ascending aorta 767.4. Results 778. Valve repair (Aicher D, Schäfers, H-J) 808.1. Background 808.2. Normal aortic valve anatomy 808.3. Differential indication, i.e., when to choose repair 818.4. Surgical techniques 828.4.1. Exposure and valve assessment 828.4.2. Correction of prolapse 838.4.3. Design alteration 868.4.4. Annuloplasty 888.5. Results 889. Valve preserving aortic replacement (Kunihara T, Schäfers H-J) 939.1. Definition of valve-preserving surgery 939.2. Indications for valve-preserving surgery 939.3. Surgical techniques 949.3.1. Root remodelling 949.3.2. Valve reimplantation 959.3.3. Aortic valve assessment and correction 969.4. Results 9710. The aorto-ventricular junction in aortic repair (Di Centa I, Lansac E) 10210.1. Anatomical rationale for aortic annuloplasty 10210.2. Aortic annuloplasty techniques and devices 10210.2.1. Suture annuloplasty 10210.2.2. Aortic rings 10311. Computer simulation of aortic valve geometry (Haj-Ali R, Marom G, Raanani E, Rosenfeld M, Schäfers H-J) 11011.1. Background 11011.2. Methods 11011.3. Effect of aortoventricular junction on cusp configuration and stress 11011.4. Effect of geometric height on cusp configuration and stress 11111.5. Clinical implications 11112. Long-term results of aortic valve surgery (Mokhles MM, Takkenberg JJM) 11412.1. Mechanical valve replacement 11512.2. Biologic valve replacement 11612.3. Autograft valve replacement 11712.4. Repair/valve-preserving aortic surgery 11912.5. Selecting the preferred surgical strategy 120...
Titel
Current treatment of aortic regurgitation
Autor
EAN
9783837454062
Format
E-Book (pdf)
Hersteller
Digitaler Kopierschutz
Wasserzeichen
Dateigrösse
13.27 MB
Anzahl Seiten
127
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