Background EuroSCORE has been proposed to identify patients at high risk for surgical aortic valve replacement and estimate for them the risk-benefit of percutaneous implantation. However, it has been clearly demonstrated that this system overestimates mortality, particularly in the elderly population undergoing surgery for aortic valve replacement. An actualized model called EuroSCORE II has b...

A 54-year-old female with acute heart failure due to aortic regurgitation (AR) was admitted to our hospital. Following admission, her condition worsened progressively; thus, surgery was performed prematurely. During surgery, two dehiscences were visualized in the aortic valve commissure between the right and left cusps and the upper part of the left coronary artery ostium. However we scheduled ...

There is a growing interest in minimally invasive access for aortic valve surgery. The upper hemi-sternotomy provides good aortic valve exposure, with numerous possible advantages. Nevertheless, some surgeons remain skeptical about limited access surgery because it is technically more demanding. Sutureless and rapid-deployment bioprostheses could alleviate these concerns by improving ease of im...

A 59-year-old male patient with Marfan's syndrome was referred to our clinic due to acute chest pain. His medical history contains complex surgery for type A aortic dissection 19 years ago including composite root replacement using a mechanical aortic valve. Immediate computed tomography indicated perforation at the distal ascending aortic anastomosis plus complete avulsion of both coronary ost...

Objective: To evaluate long term results and independent predictors of outcome of aortic valvoplasty. Design: Retrospective follow up study. Independent predictors of outcome identified by multiple logistic regression. Setting: Tertiary referral centre. Patients: 269 consecutive patients treated at the median age of 8 months (0–23 years): 80 (30%) under 4 weeks, 59 (22%) between 4 weeks and 1 y...

A 67-year-old man was referred to our hospital for an ascending aortic aneurysm, thoracoabdominal aortic aneurysm and aortic regurgitation. Graft repair of the thoracic aortic arch and aortic valve replacement was given priority and completed, however he developed descending aortic rupture before the second scheduled surgery, and endovascular stent grafting was performed. He subsequently develo...

Aortic valve replacement in the setting of critical aortic valve stenosis with cardiogenic shock is associated with high mortality, yet surgery is the only definitive treatment. We present the case of a patient with critical aortic valve stenosis and cardiogenic shock who received a short period of percutaneous mechanical support and balloon aortic valvuloplasty that resulted in rapid clinical ...

Transcatheter aortic valve implantation is an alternative to open heart surgery in high risk patients with severe aortic stenosis. High mortality and complications related to cardiopulmonary bypass for conventional open heart surgery can be avoided with this new less invasive technique. In case of concomitant severe arterial disease, the transapical approach is recommended rather than transfemo...

INTRODUCTION The transcatheter aortic valve implantation in the treatment of high-risk symptomatic aortic stenosis has increased the number of implants every year. The learning curve for transcatheter aortic valve implantation has improved since the last 12 years, allowing access alternatives. OBJECTIVE The aim of this study is to approach the implantation of transcatheter aortic valve throug...

Depending on the extent of aortic disease and surgical repair required, thoracic aortic surgery often involves periods of reduced cerebral perfusion. Historically, this resulted in detrimental neurological dysfunction, and high risk of mortality and morbidity. Over the last half century, rapid improvements have revolutionized aortic surgery. Among these, deep hypothermic circulatory arrest (DHC...