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Surgical options for the treatment of degenerative, ischemic,
inflammatory, and functional mitral valve diseases have expanded
greatly in recent decades. Still, a dilemma exists with employing
prosthetic mitral valves - in that mechanical valves exhibit good
durability but require anticoagulation versus the unpredictable
durability of biological valve prostheses. Over the past few years,
it has become clear that reconstruction of the mitral valve with
autologous tissues effectively addresses this dilemma, with no need
for anticoagulation and excellent durability, combining the best
qualities of both prosthetic options without the disadvantages.
Moreover, newer repair strategies, such as autologous pericardial
leaflet augmentation and artificial choral replacement have
expanded reparative approaches into virtually all pathologies, with
excellent long-term results as compared to prosthetic valve
replacement. At present, mitral repair is becoming the dominant
procedure for treatment of virtually all patients with mitral valve
disease. This book is designed to illustrate contemporary and
sometimes diverse surgical techniques for various types of mitral
valve repair with contributions from many of the leaders in the
field. Mitral Valve Repair and the recently published Aortic Root
Surgery are book publications arising from the Berlin Heart Valve
Symposium 2008 entitled " The Biological Solution". The Mitral
Valve Repair session was postponed to June 2009 and was featured as
the Berlin Mitral Valve Symposium at the joint meeting of the
Society for Heart Valve Diseases and the Heart Valve Society of
America in Berlin. The book contains a collection of proceedings on
current techniques and outcomes of mitral valve repair by many of
the experts in this field which provide an authoritative reference
source for cardiac surgeons, family practitioners and clinicians.
Marfan Syndrome is a hereditary disorder of connective tissue which
primarily affects the eyes, skeleton, blood vessels, and various
structures of the heart.
Since 1943, when the cardiovascular manifestations of Marfan
Syndrome were first described, understanding of its nature,
diagnostic tools, and surgical treatment have been remarkably
improved. Although the specific surgical procedures have reached an
advanced standard and general acceptance, many questions remain
unanswered and have given rise to ongoing controversy.
Cardiovascular Aspects of Marfan Syndrome presents the advances in
understanding the cause and pathogenesis of Marfan Syndrome and its
current specific surgical therapy.
Advances in heart surgical treatment have been impressive in the
last 15 years. In end-stage heart disease, procedures are now
performed routinely which were only experimental one or two decades
ago. Heart transplantation has become a well-established procedure.
According to the Gen eral Registry of the International Society of
Heart and Lung Transplantation. 40,738 heart transplantations had
been performed through the end of 1997 with survival rates of 78 %
at one year, 65 % at five years, and 42 % at ten years. The
progress in this field has been due to intense efforts in
understanding and modulating immune responses to the trans planted
heart, to elaborate therapeutic strategies to constrain infections,
and to improved out-patient care. Accordingly, heart
transplantation is integrated into the facilities of the health
care systems, the routine of physicians, and the awareness of
patients. The resulting increase in potential organ recipients has
not been met, however, by an equivalent increase of available donor
organs. This increasing discrepancy has forced the technical
improvement and clinical evalua tion of mechanical circulatory
support systems as an option for treatment of critically ill
patients with a failing heart. Initially, these assist devices were
only used to maintain sufficient circulation in post-cardiotomy
heart failure until myocardial function had recov ered. Since the
late 1980s, their primary use has been that of bridging patients
with heart failure until a suitable organ is available so that
heart transplantation can be performed."
Das Buch spannt einen weiten Bogen A1/4ber die
Transplantationsmedizin und gibt einen Aoeberblick A1/4ber
Immunologie, Chirurgie, Vorbereitung und Nachsorge sowie die
Randbereiche der Transplantationschirurgie. Es dient Chirurgen,
Internisten, Allgemeinmedizinern als auch Medizinstudenten als
Nachschlagewerk fA1/4r die thorakale und abdominelle
Organtransplantation und soll Grundlagen der
Transplantationschirurgie bzw. -medizin vermitteln. Ausserdem
informiert es den Leser A1/4ber rechtliche, ethische und
organisatorische Aspekte der Transplantationsmedizin und nicht
zuletzt A1/4ber die "Physiologie des Hirntodes und die
Spenderkonditionierung" sowie A1/4ber den Themenkomplex
"Organkonservierung, Transport und Allokation."
Imaging of the aortic root.- Perioperative imaging for assessing
aortic and mitral valve diseases and surgical procedures.-
Innovations in aortic valve surgery.- The aortic root.-
Percutaneous transluminal aortic valve replacement: The CoreValve
prosthesis.- Transapical aortic valve implantation - A truly
minimally invasive option for high-risk patients.- From minimally
invasive to percutaneous aortic valve replacement.- Sutureless
equine aortic valve replacement.- The Ross operation: Aortic valve
and root replacement with pulmonary autograft.- Pulmonary autograft
or aortic allograft for surgical treatment of active infective
aortic valve endocarditis: a review of the literature.- The Ross
operation: two decades of clinical experience.- Aortic valve repair
and valve sparing root procedures.- The bicuspid aortic valve.-
From dynamic anatomy to conservative aortic valve surgery: the tale
of the ring.- Yacoub/David techniques for aortic root operation:
success and failures.- Aortic annuloplasty.- Correction of aortic
valve incompetence combined with ascending aortic aneurysm by
relocation of the aortic valve plane through a short-length aortic
graft replacement.- Using BioGlue to achieve hemostasis in aortic
root surgery.- Endocarditis.- Challenges in the surgical management
of infective endocarditis.- Clinical results of the Shelhigh(R)
stentless bioprosthesis in patients with active infective
endocarditis: .- Double valve endocarditis and evolving paraannular
abscess formation.- Aortic root abscess: reconstruction of the left
ventricular outflow tract and allograft aortic valve and root
replacement.- Implantation techniques of freehand subcoronary
aortic valve and root replacement with a cryopreserved allograft
for aortic root abscess.- Surgery for atrial fibrillation.-
Cryoablation for the treatment of atrial fibrillation in patients
undergoing minimally invasive mitral valve surgery.- Minimally
invasive endoscopic ablation on the beating heart in patients with
lone atrial fibrillation.- Hemodynamic evaluation of the
bioprosthetic aortic valves.- Evaluation of bioprosthetic valve
performance as a function of geometric orifice area and space
efficiency- A reliable alternative to effective orifice area.-
Long-term results of biological valves.- Stented and stentless
aortic bioprostheses: competitive or complimentary?.- Edwards Prima
Plus Stentless Bioprosthesis: Long-term clinical and hemodynamic
results.- The Cryo-Life O'Brien stentless valve: 1991-2008.-
Medtronic stentless Freestyle(R) porcine aortic valve replacement.-
The ATS 3f Aortic Bioprosthesis.- The Vascutek Elan stentless
porcine prosthesis - The Glasgow experience.- Sorin pericardial
valves.- The changing role of pericardial tissue in biological
valve surgery: 22 years' experience with the Sorin Mitroflow
stented pericardial valve.- 20 years' durability of
Carpentier-Edwards Perimount stented pericardial aortic valve.-
Twenty-year experience with the St. Jude Medical Biocor
bioprosthesis in the aortic position.- 20-Year durability of
bioprostheses in the aortic position.- Clinical results including
hemodynamic performance of the Medtronic Mosaic porcine
bioprosthesis up to ten years.- Aortic root replacement with the
BioValsalva prosthesis.- Valve replacement in renal dialysis
patients: bioprostheses versus mechanical prostheses.- Replacement
of bioprostheses after structural valve deterioration.- Predictors
of patient's outcome.- Predicted outcomes after aortic valve
replacement in octogenarians with aortic stenosis.- Predicted
patient outcome after bioprosthetic AVR and the Ross operation.-
Anticoagulation.- Anticoagulation and self-management of INR:
mid-term results.- Tissue engineering.- Biomatrix-polymer hybrid
material for heart valve tissue engineering.- Standards for the in
vitro fabrication of heart valves using human umbilical cord
cells.- Tissue engineering with a decellularized valve matrix.-
Regularatory issues on tissue valves.- Human tissues for car
CARDIAC VALVE ALLOGRAFTS (HOMOGRAFTS) highlights the current
controversy about "freehand subcoronary aortic valve and root"
"replacement" with regard to postoperative morbidity and long term
durability. It discusses particular implantation techniques of
preference in young patients and in different root pathology. Other
chapters address intermediate- and long-term results on cardiac
valve and vascular homografts for treating complicating cardiac
valve and aortic infections.
The chapter on basic science additionally makes this book a highly
authoritative reference source for cardiac surgeons, physicians and
scientists.
This work provides a current survey of the state-of-the-art.
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