By Richard A. Hopkins MD (auth.)
Cryopreserved allograft tissues are actually general fabrics for the reconstructive cardiac medical professional. because booklet of the 1st variation ("Cardiac Reconstructions with Allograft Valves") in 1989, the sector has stepped forward dramatically with elevated scientific use of cardiovascular allograft tissues, with the advance of latest surgical innovations, and with advances within the knowing of the basics of valve transplantation biology and cryopreservation. for this reason, over two-thirds of the current quantity represents new fabric. Fifty-six authors carry their services to 13 accomplished, lavishly illustrated sections which debate the rules of using homograft valves, significant medical sequence of homograft valves for either left and correct ventricular outflow tracts, cryopreserved allograft tissue for cardiac reconstruction, mobile biology of middle valve leaflets, cryobiology of center valve upkeep, morphological, biochemical, and explant pathology stories of allograft middle valves, allograft valve banking, in addition to designated clarification of surgical options for valve and root equipment for left and correct ventricular outflow tract reconstructions, the Ross operation and versions, and complicated reconstructions. a last part offers capability destiny instructions for the sphere. Over four hundred illustrations, created expressly for this e-book, depict the surgical thoughts from the viewpoint of the health practitioner status on the working desk. All surgeons appearing pediatric and/or grownup valve replacements and reconstructive cardiac surgical procedures will enjoy the defined tools. Cardiothoracic citizens and cardiologists also will locate the textual content worthwhile. it is going to give you the health professional with an improved knowing of the organic and fabric homes of allografts and elevated familiarity with the diversity of surgical ideas appropriate for using those valves, fairly within the winning administration of difficult cardiac reconstructions.>
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Extra info for Cardiac Reconstructions with Allograft Tissues
Except when performing a preliminary annular reduction, we avoid reconstruction with pledgets, Teﬂon buttresses or circumferential retaining collars as these may later distort the valvular mechanism and reduce coaptation. In our opinion, prosthetic material is best avoided in the presence of infection. d) Re-replacement In the event of re-replacement after previous modiﬁed allograft root replacement, use of alternative techniques are made much easier if, at the ﬁrst operation, there has not been extensive root dissection, and the aortic root is still intact.
Follow up of this group of patients was reported at varying intervals. 3–6 Patients The median age of the 250 patients operated was 48 years, (range 5–69 years). There were 186 males and 64 females. Fifteen (15) patients had had previous operations on the aortic valve. The dominant lesion was aortic stenosis in 123 patients, aortic insufﬁciency in 49 patients, and mixed stenosis and insufﬁciency in 78 patients. Seventy-nine patients required additional procedures at the time of AVR for various associated lesions; mitral valve repair in 21, mitral replacement in 21, ventricular septal defect repair in 2, and aortic root reconstruction in 55.
Cardiac valve prostheses: pathological and bioengineering considerations. J Cardiac Surg 1987;2:65–108. 38. Dale J, Levang O, Eng I. Long-term results after aortic valve replacement with four different prostheses. Amer Heart J 1980;99:155–162. 39. Bjork VO, Henze A, Homgren A. Five years’ experience with the Bjork-Shiley tilting-disc valve in isolated aortic valvular disease. J Thorac Cardiovasc Surg 1974;68:393–404. 40. Schaff HV, Borkon AM, Hughes C, et al. Clinical and hemodynamic evaluation of the 19-mm Bjork-Shiley aortic valve prosthesis.
Cardiac Reconstructions with Allograft Tissues by Richard A. Hopkins MD (auth.)