AORT

KAPAK TAMRLER
AHMET OZKARA
KALP VE DAMAR CERRAHS

 1958 Taylor, 1963 Ross lk cerrahi dzeltme

1980s transesophageal echocardiography
Duran (1988) , Cosgrove (1991) ilk kapak
tamiri
Yacoub (1993) and David (1992) kapak
koruyucu operasyonlar

BENTALL
PROCEDURE

I
II
III
IV
V

ReimplantaUon Original
Remodeling Original
Remodeling with an external strip in the
brous porUon of basal ring
ReimplantaUon with plicaUon of the graZ at
ST juncUon
ReimplantaUon with plicaUon of the graZ at
both the basal ring and ST juncUon to create
the graZ pseudosinus

Aor3c valve sparing opera3ons: outcomes at 20 years

Tirone E. David Ann Cardiothorac Surg 2013;2(1):24-29
Variable

Reimplanta3on
Number of opera3ons

296

Size of graP [mean SD, mm]
31.52.4
Plica3on of free margin of aor3c cusps:

One cusp


81 [27.3]
Two cusps


27 [9.1]
Three cusps


15 [5]
Reinforcement of free margin
68 [23]
Crea3on of neo-aor3c sinuses
115 [38.8]
Replacement of aor3c arch
55 [15]
Aor3c clamp 3me

117326
Cardiopulmonary bypass
14132

Remodeling
78

28.12.0
15 [19.2]
5 [6.4]
0

9 [11.5]
78 [100]
13 [17]
10125
12532

CUSP HEIGHT

Cusp Height in aorUc valves . J Thorac Cardiovasc Surg 2013;146:269-74

CUSP HEIGHT

Geometric Height 16 mm or less in TAV
Geometric Height 19 mm or less in BAV.

ConservaUve AorUc Valve Surgery for AorUc Insuciency and

Aneurysms of the AorUc Root (CAVIAAR)

Ann Cardiothorac Surg 2013;2(1):117-123

AorUc Root Aneurysm

Valsalva 45 mm

Supra-coronary aneurysm
Valsalva <40 mm
Supracoronary Aorta >45

Isolated Al
Valsalva <40 mm
Supracoronary
Aorta <40

Remodeling
+ sub-valvular
annuloplasty

Supra-coronary
graZ + sub-valvular
annuloplasty
(annulus 25 mm)

Sub-valvular
annuloplasty
(annulus 25 mm)

Eur J Cardiothorac Surg. 2014 Apr

An expansible aor3c ring to preserve aor3c root dynamics aPer aor3c valve repair.
Wuliya M1, Sleilaty G, Di Centa I, Khelil N, Berrebi A, Czitrom D, Mankoubi L,
Noghin M, Malergue MC, Chatellier G, Debauchez M, Lansac E.

First results of the study

During the median 19-month follow-up, annular diameter and cusp
eec3ve height remained stable.
There were no valve-related reopera3ons.
Freedom from AI grade 2 was 100% at 1-year follow-up and 96.8%
3.2% at 3-year follow-up.

CONCLUSION
As surgical techniques for aor3c valve repair
con3nue to evolve, clinical outcomes up to
and beyond the rst decade are promising
with excellent survival and low risk of valve
related events