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Valve Surgery PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Valve Surgery" by V.Rohn.
This medical PowerPoint presentation talks about Valve surgery, a complex procedure that requires skilled surgeons and specialized medical equipment.
Valve surgery refers to a surgical procedure that is performed to repair or replace a heart valve. The heart has four valves - the aortic valve, pulmonary valve, mitral valve, and tricuspid valve. These valves help regulate blood flow through the heart, and any damage or malfunction can lead to serious health problems.

Tags : Valve Surgery, surgical procedure, heart valve, aortic valve, pulmonary valve, mitral valve, tricuspid valve, Cardiothoracic Surgery, cardiology, cardiology PowerPoint presentation

Published on : Mar 21, 2023 | Views : 2525 | Downloads : 2

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Slide 1-

Valve Surgery V.Rohn
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Valve Surgery History before the era of ECC 1925 – Suttar – first successful digital commisurolysis of mitral valve 1952 – Hufnagel – first mechanical „ball and cage“ valve implanted to the descending aorta
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Valve Surgery History With ECC 1960 – Harken – aortic valve replacement with the „ball and cage“ valve 1960 – Starr – replacement of the mitral valve
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Valve Surgery 1962 – Heimbecher – first use of the homograft in the mitral position 1967 – Ross – autograft of pulmonary valve in the aortic position 1971 – Carpentier – introduction of „bioprosthesis“, e.g. xenograft as a valve replacement 1983 – Carpentier –mitral valve plasty (reconstruction) concept
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Aortic Valve Stenosis Etiology degenerative congenital (bicuspid valve) rheumatic Symptoms angina pectoris syncope dyspnea
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Aortic valve Anatomy
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Stenosis of the aortic valve Indications for surgery symptoms asymptomatic – AVA 0,75cm2/m2 and less pressure gradient 45 – 50mmHg low EF is not a contraindication Procedure Aortic valve replacement
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Aortic valve regurgitation Etiology multiple Symptoms None - very long time angina pectoris dyspnea
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Aortic valve regurgitation Indication for surgery Symptoms or first signs of LV function deterioration EF < 55 % Dilatation of LV (EDD > 75 mm, ESD > 50 mm) Procedure Replacement Reconstruction
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Aortic valve Replacement
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Aortic root enlargement – Manougian, Nicks
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Allograft, Pulmonary autograft
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Percutaneous or transapical implantation – 1965 Davies Lancet 1965;62:926—9.
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Endovascular or transapical AVR
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Copyright ©2009 The American Association for Thoracic Surgery Boodhwani M. et al.; J Thorac Cardiovasc Surg 2009;137:286-294 Repair-oriented functional classification of aortic insufficiency (AI) with description of disease mechanisms and repair techniques used
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Aortic Valve Repair
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Mitral stenosis Etiology mostly rheumatic Symptoms long time asymptomatic dyspnea embolization (atrial fib.) Indication for surgery valve area less than 0,8 cm2/m2 pressure gradient above 8-10 mmHg
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Mitral stenosis percutaneous balloon valvuloplasty „closed“ commissurotomy „open“ commissurotomy replacement
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Mitral stenosis – open commissurotomy
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Mitral stenosis – closed commissurotomy
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Mitral regurgitation Etiology rheumatic Degenerative mitral regurg. (fibroelastic, myxomatous, Barlow disease) Ischemic symptoms dyspnea a.fib., embolization
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Mitral regurgitation Indication regurgitation more than 2-3/5 (echo, ventriculography) LV dilatation (ESD more than 55 mm) LV dysfunction, EF decrease Procedure 90% of degenerative mitral valves are amenable to repair replacement with preservation of the subvalvular apparatus
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Mitral valve - anatomy
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Mitral valve repair – Valve Exposure
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Mitral valve repair- quadrangular resection of the posterior leaflet
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Chordal transfer
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Ischemic Mitral Regurgitation
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Ischemic Mitral Regurgitation
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Undersized Annuloplasty
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Tricuspid valve
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Etiology Congenital – ASD, VSD, Ebstein disease pacemaker or automatic internal cardiac defibrillation (AICD) wires carcinoid lupus erythematosus, cor pulmonale, inferior myocardial infarction, scleroderma Functional- secondary to cardiac valvular pathology (mostly mitral valve disease) up to 20% of patients undergoing mitral valve replacement receive a tricuspid annuloplasty less than 2% require replacement
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Indication to surgery during left-sided valve surgery when TR annulus is dilated >21 mm/m2; >70 mm intra-operatively; >3.5 cm at TTE Symptomatic stenosis or regurg.
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De Vega plasty
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Rings and Bands
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Tricuspid valve repalcement
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Valve Prosthesis biological mechanical homograft autograft
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Mechanical vs biological lifelong anticoagulation therapy degeneration
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ESC guidelines 2007
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