Aortic valve repair: Difference between revisions
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{{SI}} | {{SI}} | ||
{{CMG}} | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} | ||
'''Associate Editor-In-Chief:''' {{CZ}} | |||
==Overview== | ==Overview== | ||
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*The '''Reimplantation Technique''', established by Tirone David. | *The '''Reimplantation Technique''', established by Tirone David. | ||
==2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) <ref name=" | ==2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>== | ||
=== | ===Aortic Valve Selection (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>=== | ||
{|class="wikitable" | {|class="wikitable" | ||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' A mechanical [[prosthesis]] is recommended for [[AVR]] in patients with a [[mechanical valve]] in the [[mitral valve|mitral]] or [[tricuspid valve|tricuspid]] position. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' A mechanical [[prosthesis]] is recommended for [[AVR]] in patients with a [[mechanical valve]] in the [[mitral valve|mitral]] or [[tricuspid valve|tricuspid]] position. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A bioprosthesis is recommended for [[AVR]] in patients of any age who will not take [[warfarin]] or who have major medical contraindications to [[warfarin]] therapy. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A bioprosthesis is recommended for [[AVR]] in patients of any age who will not take [[warfarin]] or who have major medical contraindications to [[warfarin]] therapy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Patient preference is a reasonable consideration in the selection of [[aortic valve]] operation and valve [[prosthesis]]. A mechanical [[prosthesis]] is reasonable for [[AVR]] in patients under 65 years of age who do not have a contraindication to [[anticoagulation]]. A bioprosthesis is reasonable for [[AVR]] in patients under 65 years of age who elect to receive this valve for lifestyle considerations after detailed discussions of the risks of [[anticoagulation]] versus the likelihood that a second [[AVR]] may be necessary in the future. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Patient preference is a reasonable consideration in the selection of [[aortic valve]] operation and valve [[prosthesis]]. A mechanical [[prosthesis]] is reasonable for [[AVR]] in patients under 65 years of age who do not have a contraindication to [[anticoagulation]]. A bioprosthesis is reasonable for [[AVR]] in patients under 65 years of age who elect to receive this valve for lifestyle considerations after detailed discussions of the risks of [[anticoagulation]] versus the likelihood that a second [[AVR]] may be necessary in the future. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' A bioprosthesis is reasonable for [[AVR]] in patients aged 65 years or older without risk factors for [[thromboembolism]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' A bioprosthesis is reasonable for [[AVR]] in patients aged 65 years or older without risk factors for [[thromboembolism]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[Aortic valve rereplacement]] with a [[homograft]] is reasonable for patients with active [[prosthetic valve endocarditis]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[Aortic valve rereplacement]] with a [[homograft]] is reasonable for patients with active [[prosthetic valve endocarditis]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' A bioprosthesis might be considered for [[AVR]] in a woman of childbearing age. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' A bioprosthesis might be considered for [[AVR]] in a woman of childbearing age. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |||
===Intraoperative Assessment (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>=== | |||
{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Intraoperative [[transesophageal echocardiography]] is recommended for valve repair surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|} | |||
{|class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
|- | |||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Intraoperative [[transesophageal echocardiography]] is reasonable for all patients undergoing cardiac valve surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|} | |} | ||
==Sources== | ==Sources== | ||
*2008 | *2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref> | ||
==References== | |||
{{Reflist|2}} | |||
==Related Chapters== | ==Related Chapters== | ||
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{{Circulatory system pathology}} | {{Circulatory system pathology}} | ||
[[uk:Пластика аортального клапану]] | [[uk:Пластика аортального клапану]] | ||
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{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 23:31, 14 March 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Aortic valve repair is a surgical procedure used to correct some aortic valve disorders. It is an alternative to aortic valve replacement. Aortic valve repair is performed less often and is more technically difficult than mitral valve repair. There are two surgical techniques tor repair an aortic valve:
- The Remodeling Technique, established by Sir Magdi Yacoub and
- The Reimplantation Technique, established by Tirone David.
2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) [1]
Aortic Valve Selection (DO NOT EDIT) [1]
| Class I |
| "1. A mechanical prosthesis is recommended for AVR in patients with a mechanical valve in the mitral or tricuspid position. (Level of Evidence: C)" |
| "2. A bioprosthesis is recommended for AVR in patients of any age who will not take warfarin or who have major medical contraindications to warfarin therapy. (Level of Evidence: C)" |
| Class IIa |
| "1. Patient preference is a reasonable consideration in the selection of aortic valve operation and valve prosthesis. A mechanical prosthesis is reasonable for AVR in patients under 65 years of age who do not have a contraindication to anticoagulation. A bioprosthesis is reasonable for AVR in patients under 65 years of age who elect to receive this valve for lifestyle considerations after detailed discussions of the risks of anticoagulation versus the likelihood that a second AVR may be necessary in the future. (Level of Evidence: C)" |
| "2. A bioprosthesis is reasonable for AVR in patients aged 65 years or older without risk factors for thromboembolism. (Level of Evidence: C)" |
| "3. Aortic valve rereplacement with a homograft is reasonable for patients with active prosthetic valve endocarditis. (Level of Evidence: C)" |
| Class IIb |
| "1. A bioprosthesis might be considered for AVR in a woman of childbearing age. (Level of Evidence: C)" |
Intraoperative Assessment (DO NOT EDIT) [1]
| Class I |
| "1. Intraoperative transesophageal echocardiography is recommended for valve repair surgery. (Level of Evidence: B)" |
| Class IIa |
| "1. Intraoperative transesophageal echocardiography is reasonable for all patients undergoing cardiac valve surgery. (Level of Evidence: C)" |
Sources
- 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease [1]
References
- ↑ 1.0 1.1 1.2 1.3 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
|month=ignored (help)
Related Chapters