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The aortic valve is opened during systole, the driving force for it to open is the difference in pressure between the contracting left ventricle of the heart and the aorta. During cardiac diastole (when the heart chamber gets bigger) the aortic valve closes. [5] Aortic stenosis most commonly is the result of calcification of the cusps.
Many years after the procedure is done, heart disease not only has an increased chance of affecting coarctation patients, but also progresses through the levels of severity at an alarmingly increased rate. In one study, one fourth of the patients who experienced a coarctation later died of heart disease, some at a relatively young age. [22] [23]
Diagram of the human heart. Several adaptations of the Ross procedure have evolved, but the principle is essentially the same; to replace a diseased aortic valve with the person's own pulmonary valve (autograft), and replace the person's own pulmonary valve with a pulmonary valve from a cadaver (homograft) or a stentless xenograft.
The open-heart surgery entails removing a portion of the septum that is obstructing the flow of blood from the left ventricle to the aorta. [ 2 ] The most common alternatives to septal myectomies are treatment with medication (usually beta or calcium blockers ) or non-surgical thinning of tissue with alcohol ablation .
This procedure makes heart surgery possible for patients who were previously considered too high risk for traditional surgery due to age or medical history. [ 5 ] [ 6 ] Patients referred for this procedure may have coronary artery disease (CAD); aortic, mitral or tricuspid valve diseases; or previous unsuccessful stenting.
The Mustard procedure was largely replaced in the late 1980s by the Jatene procedure (arterial switch), in which the native arteries were switched back to normal flow, so that the RV (right ventricle) would be connected to the pulmonary artery and the LV (left ventricle) would be connected to the aorta. This surgery had not been possible prior ...
Current aortic valve replacement approaches include closed heart surgery, Very invasive cardiac surgery (VICS) and Very invasive, Scapulae-based aortic valve replacement. Catheter replacement of the aortic valve (called trans-aortic valve replacement or implementation [TAVR or TAVI]) is a minimally invasive option for those suffering from ...
After a few years, the survival after repair is similar to EVAR or open surgery. This observation may be the result of durability problems with early endograft, with a corresponding need for additional procedures to repair endoleaks and other device-related issues. Newer, improved technology may reduce the need for such secondary procedures.