Structural abnormalities after aortic root replacement with stentless xenograft
In complex and high-risk aortic root disease, the porcine Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, Minn) is an important surgical treatment option. We aimed to determine prevalence and clinical effect of structural and functional abnormalities after full-root Freestyle implanta...
Gespeichert in:
Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2023-04, Vol.165 (4), p.1285-1297.e6 |
---|---|
Hauptverfasser: | , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 1297.e6 |
---|---|
container_issue | 4 |
container_start_page | 1285 |
container_title | The Journal of thoracic and cardiovascular surgery |
container_volume | 165 |
creator | Dagnegård, Hanna Sofia Holmgren Sigvardsen, Per Ejlstrup Ihlemann, Nikolaj Kofoed, Klaus Fuglsang El-Hamamsy, Ismail Bekke, Kirstine Valentin, Jan Brink Lefebvre, Laurence Johnsen, Søren Paaske Søndergaard, Lars Lund, Jens Teglgaard Smerup, Morten Holdgaard |
description | In complex and high-risk aortic root disease, the porcine Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, Minn) is an important surgical treatment option. We aimed to determine prevalence and clinical effect of structural and functional abnormalities after full-root Freestyle implantation.
Our cross-sectional 2-center study combined with clinical follow-up included 253 patients with full-root Freestyle bioprostheses implanted from 1999 to 2017. Patients underwent transthoracic echocardiography (TTE) and contrast-enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) at median age 70 (interquartile range, 62-75) years. After 4DCT, clinical follow-up continued throughout 2018. Median follow-up was 3.3 years before 4DCT and 1.4 years after.
We identified abnormalities in 46% of patients, including pseudoaneurysms (n = 32; 13%), moderate or severe coronary ostial stenosis (n = 54; 21%), and moderate-severe leaflet thickening or reduced leaflet motion (n = 51; 20%). TTE only identified 1 patient with pseudoaneurysm. After 4DCT, the unadjusted hazard ratio for surgical reintervention among patients with abnormal 4DCT was 4.2 (95% confidence interval, 1.2-15.3), in all, 10% required a reintervention. 4DCT abnormalities were associated with a statistically nonsignificant increased risk of death, stroke, or myocardial infarction (hazard ratio obtained using Cox proportional hazards regression analysis, 2.4; 95% confidence interval, 0.7-7.6). In all, 4.0% died, 3.6% had a myocardial infarction, and 2.0% had a stroke.
Structural and functional abnormalities of the aortic root are frequent after Freestyle implantation and TTE appears to be insufficient for follow-up. Abnormalities might be associated with increased risk of reintervention and potentially adverse clinical outcomes. Longer follow-up and larger study populations are needed to further clarify the clinical implications of abnormalities identified with 4DCT.
This study comprised a cross-sectional analysis of 253 survivors after full root Freestyle (Medtronic Inc, Minneapolis, Minn) implantation in 2 institutions. Study participants were examined using contrast enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) with the purpose of identifying structural abnormalities. Pseudoaneurysms, significant ostial coronary stenoses, or leaflet abnormalities (hypoattenuated leaflet thickness or reduced leaflet motion) were found in 46% and were no |
doi_str_mv | 10.1016/j.jtcvs.2021.04.087 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2540518036</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522321007923</els_id><sourcerecordid>2540518036</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-f846edac888946c270960dff6e1edcf6d75b9eb6788e3a814379db9a640cbfe93</originalsourceid><addsrcrecordid>eNp9kLtOxDAQRS0EYpfHFyChlDQJ48Rx7IICIV4SEgUg0VmOMwGvknixnQX-nsAulFQzxblzNYeQIwoZBcpPF9kimlXIcshpBiwDUW2ROQVZpVyUz9tkDpDnaZnnxYzshbAAgAqo3CWzglE6MWxO7h-iH00cve4SXQ_O97qz0WJIdBvRJ9r5aE3inYuJx2WnDfY4xOTdxtckxGntMITkAwf34qfIAdlpdRfwcDP3ydPV5ePFTXp3f317cX6XmqKUMW0F49hoI4SQjJu8AsmhaVuOFBvT8qYqa4k1r4TAQgvKiko2tdScgalblMU-OVnfXXr3NmKIqrfBYNfpAd0YVF4yKKmAgk9osUaNdyF4bNXS2177T0VBfZtUC_VjUn2bVMDUZHJKHW8KxrrH5i_zq24CztYATm-uLHoVjMXBYGM9mqgaZ_8t-AKexogW</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2540518036</pqid></control><display><type>article</type><title>Structural abnormalities after aortic root replacement with stentless xenograft</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Dagnegård, Hanna Sofia Holmgren ; Sigvardsen, Per Ejlstrup ; Ihlemann, Nikolaj ; Kofoed, Klaus Fuglsang ; El-Hamamsy, Ismail ; Bekke, Kirstine ; Valentin, Jan Brink ; Lefebvre, Laurence ; Johnsen, Søren Paaske ; Søndergaard, Lars ; Lund, Jens Teglgaard ; Smerup, Morten Holdgaard</creator><creatorcontrib>Dagnegård, Hanna Sofia Holmgren ; Sigvardsen, Per Ejlstrup ; Ihlemann, Nikolaj ; Kofoed, Klaus Fuglsang ; El-Hamamsy, Ismail ; Bekke, Kirstine ; Valentin, Jan Brink ; Lefebvre, Laurence ; Johnsen, Søren Paaske ; Søndergaard, Lars ; Lund, Jens Teglgaard ; Smerup, Morten Holdgaard</creatorcontrib><description>In complex and high-risk aortic root disease, the porcine Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, Minn) is an important surgical treatment option. We aimed to determine prevalence and clinical effect of structural and functional abnormalities after full-root Freestyle implantation.
Our cross-sectional 2-center study combined with clinical follow-up included 253 patients with full-root Freestyle bioprostheses implanted from 1999 to 2017. Patients underwent transthoracic echocardiography (TTE) and contrast-enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) at median age 70 (interquartile range, 62-75) years. After 4DCT, clinical follow-up continued throughout 2018. Median follow-up was 3.3 years before 4DCT and 1.4 years after.
We identified abnormalities in 46% of patients, including pseudoaneurysms (n = 32; 13%), moderate or severe coronary ostial stenosis (n = 54; 21%), and moderate-severe leaflet thickening or reduced leaflet motion (n = 51; 20%). TTE only identified 1 patient with pseudoaneurysm. After 4DCT, the unadjusted hazard ratio for surgical reintervention among patients with abnormal 4DCT was 4.2 (95% confidence interval, 1.2-15.3), in all, 10% required a reintervention. 4DCT abnormalities were associated with a statistically nonsignificant increased risk of death, stroke, or myocardial infarction (hazard ratio obtained using Cox proportional hazards regression analysis, 2.4; 95% confidence interval, 0.7-7.6). In all, 4.0% died, 3.6% had a myocardial infarction, and 2.0% had a stroke.
Structural and functional abnormalities of the aortic root are frequent after Freestyle implantation and TTE appears to be insufficient for follow-up. Abnormalities might be associated with increased risk of reintervention and potentially adverse clinical outcomes. Longer follow-up and larger study populations are needed to further clarify the clinical implications of abnormalities identified with 4DCT.
This study comprised a cross-sectional analysis of 253 survivors after full root Freestyle (Medtronic Inc, Minneapolis, Minn) implantation in 2 institutions. Study participants were examined using contrast enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) with the purpose of identifying structural abnormalities. Pseudoaneurysms, significant ostial coronary stenoses, or leaflet abnormalities (hypoattenuated leaflet thickness or reduced leaflet motion) were found in 46% and were not seen on transthoracic echocardiography. The abnormalities might require reintervention, which is why the authors recommend serial follow-up after aortic root replacement with cardiac computed tomography (CT) or magnetic resonance imaging (MRI) in addition to echocardiography. PA, Pulmonary artery; LM, left main coronary artery; LVOT, left ventricular outflow tract; PV, pulmonary valve. [Display omitted]</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2021.04.087</identifier><identifier>PMID: 34116854</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Animals ; aortic root replacement ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Bioprosthesis ; coronary ostial stenosis ; Cross-Sectional Studies ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - adverse effects ; Heterografts ; Humans ; leaflet abnormalities ; Myocardial Infarction - surgery ; Prosthesis Design ; pseudoaneurysm ; reimplanted coronaries ; stentless Freestyle bioprosthesis ; Swine ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2023-04, Vol.165 (4), p.1285-1297.e6</ispartof><rights>2021 The American Association for Thoracic Surgery</rights><rights>Copyright © 2021 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-f846edac888946c270960dff6e1edcf6d75b9eb6788e3a814379db9a640cbfe93</citedby><cites>FETCH-LOGICAL-c359t-f846edac888946c270960dff6e1edcf6d75b9eb6788e3a814379db9a640cbfe93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2021.04.087$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34116854$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dagnegård, Hanna Sofia Holmgren</creatorcontrib><creatorcontrib>Sigvardsen, Per Ejlstrup</creatorcontrib><creatorcontrib>Ihlemann, Nikolaj</creatorcontrib><creatorcontrib>Kofoed, Klaus Fuglsang</creatorcontrib><creatorcontrib>El-Hamamsy, Ismail</creatorcontrib><creatorcontrib>Bekke, Kirstine</creatorcontrib><creatorcontrib>Valentin, Jan Brink</creatorcontrib><creatorcontrib>Lefebvre, Laurence</creatorcontrib><creatorcontrib>Johnsen, Søren Paaske</creatorcontrib><creatorcontrib>Søndergaard, Lars</creatorcontrib><creatorcontrib>Lund, Jens Teglgaard</creatorcontrib><creatorcontrib>Smerup, Morten Holdgaard</creatorcontrib><title>Structural abnormalities after aortic root replacement with stentless xenograft</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>In complex and high-risk aortic root disease, the porcine Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, Minn) is an important surgical treatment option. We aimed to determine prevalence and clinical effect of structural and functional abnormalities after full-root Freestyle implantation.
Our cross-sectional 2-center study combined with clinical follow-up included 253 patients with full-root Freestyle bioprostheses implanted from 1999 to 2017. Patients underwent transthoracic echocardiography (TTE) and contrast-enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) at median age 70 (interquartile range, 62-75) years. After 4DCT, clinical follow-up continued throughout 2018. Median follow-up was 3.3 years before 4DCT and 1.4 years after.
We identified abnormalities in 46% of patients, including pseudoaneurysms (n = 32; 13%), moderate or severe coronary ostial stenosis (n = 54; 21%), and moderate-severe leaflet thickening or reduced leaflet motion (n = 51; 20%). TTE only identified 1 patient with pseudoaneurysm. After 4DCT, the unadjusted hazard ratio for surgical reintervention among patients with abnormal 4DCT was 4.2 (95% confidence interval, 1.2-15.3), in all, 10% required a reintervention. 4DCT abnormalities were associated with a statistically nonsignificant increased risk of death, stroke, or myocardial infarction (hazard ratio obtained using Cox proportional hazards regression analysis, 2.4; 95% confidence interval, 0.7-7.6). In all, 4.0% died, 3.6% had a myocardial infarction, and 2.0% had a stroke.
Structural and functional abnormalities of the aortic root are frequent after Freestyle implantation and TTE appears to be insufficient for follow-up. Abnormalities might be associated with increased risk of reintervention and potentially adverse clinical outcomes. Longer follow-up and larger study populations are needed to further clarify the clinical implications of abnormalities identified with 4DCT.
This study comprised a cross-sectional analysis of 253 survivors after full root Freestyle (Medtronic Inc, Minneapolis, Minn) implantation in 2 institutions. Study participants were examined using contrast enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) with the purpose of identifying structural abnormalities. Pseudoaneurysms, significant ostial coronary stenoses, or leaflet abnormalities (hypoattenuated leaflet thickness or reduced leaflet motion) were found in 46% and were not seen on transthoracic echocardiography. The abnormalities might require reintervention, which is why the authors recommend serial follow-up after aortic root replacement with cardiac computed tomography (CT) or magnetic resonance imaging (MRI) in addition to echocardiography. PA, Pulmonary artery; LM, left main coronary artery; LVOT, left ventricular outflow tract; PV, pulmonary valve. [Display omitted]</description><subject>Aged</subject><subject>Animals</subject><subject>aortic root replacement</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Bioprosthesis</subject><subject>coronary ostial stenosis</subject><subject>Cross-Sectional Studies</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heterografts</subject><subject>Humans</subject><subject>leaflet abnormalities</subject><subject>Myocardial Infarction - surgery</subject><subject>Prosthesis Design</subject><subject>pseudoaneurysm</subject><subject>reimplanted coronaries</subject><subject>stentless Freestyle bioprosthesis</subject><subject>Swine</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtOxDAQRS0EYpfHFyChlDQJ48Rx7IICIV4SEgUg0VmOMwGvknixnQX-nsAulFQzxblzNYeQIwoZBcpPF9kimlXIcshpBiwDUW2ROQVZpVyUz9tkDpDnaZnnxYzshbAAgAqo3CWzglE6MWxO7h-iH00cve4SXQ_O97qz0WJIdBvRJ9r5aE3inYuJx2WnDfY4xOTdxtckxGntMITkAwf34qfIAdlpdRfwcDP3ydPV5ePFTXp3f317cX6XmqKUMW0F49hoI4SQjJu8AsmhaVuOFBvT8qYqa4k1r4TAQgvKiko2tdScgalblMU-OVnfXXr3NmKIqrfBYNfpAd0YVF4yKKmAgk9osUaNdyF4bNXS2177T0VBfZtUC_VjUn2bVMDUZHJKHW8KxrrH5i_zq24CztYATm-uLHoVjMXBYGM9mqgaZ_8t-AKexogW</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Dagnegård, Hanna Sofia Holmgren</creator><creator>Sigvardsen, Per Ejlstrup</creator><creator>Ihlemann, Nikolaj</creator><creator>Kofoed, Klaus Fuglsang</creator><creator>El-Hamamsy, Ismail</creator><creator>Bekke, Kirstine</creator><creator>Valentin, Jan Brink</creator><creator>Lefebvre, Laurence</creator><creator>Johnsen, Søren Paaske</creator><creator>Søndergaard, Lars</creator><creator>Lund, Jens Teglgaard</creator><creator>Smerup, Morten Holdgaard</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202304</creationdate><title>Structural abnormalities after aortic root replacement with stentless xenograft</title><author>Dagnegård, Hanna Sofia Holmgren ; Sigvardsen, Per Ejlstrup ; Ihlemann, Nikolaj ; Kofoed, Klaus Fuglsang ; El-Hamamsy, Ismail ; Bekke, Kirstine ; Valentin, Jan Brink ; Lefebvre, Laurence ; Johnsen, Søren Paaske ; Søndergaard, Lars ; Lund, Jens Teglgaard ; Smerup, Morten Holdgaard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-f846edac888946c270960dff6e1edcf6d75b9eb6788e3a814379db9a640cbfe93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Animals</topic><topic>aortic root replacement</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Bioprosthesis</topic><topic>coronary ostial stenosis</topic><topic>Cross-Sectional Studies</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heterografts</topic><topic>Humans</topic><topic>leaflet abnormalities</topic><topic>Myocardial Infarction - surgery</topic><topic>Prosthesis Design</topic><topic>pseudoaneurysm</topic><topic>reimplanted coronaries</topic><topic>stentless Freestyle bioprosthesis</topic><topic>Swine</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dagnegård, Hanna Sofia Holmgren</creatorcontrib><creatorcontrib>Sigvardsen, Per Ejlstrup</creatorcontrib><creatorcontrib>Ihlemann, Nikolaj</creatorcontrib><creatorcontrib>Kofoed, Klaus Fuglsang</creatorcontrib><creatorcontrib>El-Hamamsy, Ismail</creatorcontrib><creatorcontrib>Bekke, Kirstine</creatorcontrib><creatorcontrib>Valentin, Jan Brink</creatorcontrib><creatorcontrib>Lefebvre, Laurence</creatorcontrib><creatorcontrib>Johnsen, Søren Paaske</creatorcontrib><creatorcontrib>Søndergaard, Lars</creatorcontrib><creatorcontrib>Lund, Jens Teglgaard</creatorcontrib><creatorcontrib>Smerup, Morten Holdgaard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dagnegård, Hanna Sofia Holmgren</au><au>Sigvardsen, Per Ejlstrup</au><au>Ihlemann, Nikolaj</au><au>Kofoed, Klaus Fuglsang</au><au>El-Hamamsy, Ismail</au><au>Bekke, Kirstine</au><au>Valentin, Jan Brink</au><au>Lefebvre, Laurence</au><au>Johnsen, Søren Paaske</au><au>Søndergaard, Lars</au><au>Lund, Jens Teglgaard</au><au>Smerup, Morten Holdgaard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Structural abnormalities after aortic root replacement with stentless xenograft</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2023-04</date><risdate>2023</risdate><volume>165</volume><issue>4</issue><spage>1285</spage><epage>1297.e6</epage><pages>1285-1297.e6</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>In complex and high-risk aortic root disease, the porcine Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, Minn) is an important surgical treatment option. We aimed to determine prevalence and clinical effect of structural and functional abnormalities after full-root Freestyle implantation.
Our cross-sectional 2-center study combined with clinical follow-up included 253 patients with full-root Freestyle bioprostheses implanted from 1999 to 2017. Patients underwent transthoracic echocardiography (TTE) and contrast-enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) at median age 70 (interquartile range, 62-75) years. After 4DCT, clinical follow-up continued throughout 2018. Median follow-up was 3.3 years before 4DCT and 1.4 years after.
We identified abnormalities in 46% of patients, including pseudoaneurysms (n = 32; 13%), moderate or severe coronary ostial stenosis (n = 54; 21%), and moderate-severe leaflet thickening or reduced leaflet motion (n = 51; 20%). TTE only identified 1 patient with pseudoaneurysm. After 4DCT, the unadjusted hazard ratio for surgical reintervention among patients with abnormal 4DCT was 4.2 (95% confidence interval, 1.2-15.3), in all, 10% required a reintervention. 4DCT abnormalities were associated with a statistically nonsignificant increased risk of death, stroke, or myocardial infarction (hazard ratio obtained using Cox proportional hazards regression analysis, 2.4; 95% confidence interval, 0.7-7.6). In all, 4.0% died, 3.6% had a myocardial infarction, and 2.0% had a stroke.
Structural and functional abnormalities of the aortic root are frequent after Freestyle implantation and TTE appears to be insufficient for follow-up. Abnormalities might be associated with increased risk of reintervention and potentially adverse clinical outcomes. Longer follow-up and larger study populations are needed to further clarify the clinical implications of abnormalities identified with 4DCT.
This study comprised a cross-sectional analysis of 253 survivors after full root Freestyle (Medtronic Inc, Minneapolis, Minn) implantation in 2 institutions. Study participants were examined using contrast enhanced, electrocardiogram-gated 4-dimensional cardiac computed tomography (4DCT) with the purpose of identifying structural abnormalities. Pseudoaneurysms, significant ostial coronary stenoses, or leaflet abnormalities (hypoattenuated leaflet thickness or reduced leaflet motion) were found in 46% and were not seen on transthoracic echocardiography. The abnormalities might require reintervention, which is why the authors recommend serial follow-up after aortic root replacement with cardiac computed tomography (CT) or magnetic resonance imaging (MRI) in addition to echocardiography. PA, Pulmonary artery; LM, left main coronary artery; LVOT, left ventricular outflow tract; PV, pulmonary valve. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34116854</pmid><doi>10.1016/j.jtcvs.2021.04.087</doi></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0022-5223 |
ispartof | The Journal of thoracic and cardiovascular surgery, 2023-04, Vol.165 (4), p.1285-1297.e6 |
issn | 0022-5223 1097-685X |
language | eng |
recordid | cdi_proquest_miscellaneous_2540518036 |
source | MEDLINE; Elsevier ScienceDirect Journals Complete |
subjects | Aged Animals aortic root replacement Aortic Valve - diagnostic imaging Aortic Valve - surgery Bioprosthesis coronary ostial stenosis Cross-Sectional Studies Follow-Up Studies Heart Valve Prosthesis Heart Valve Prosthesis Implantation - adverse effects Heterografts Humans leaflet abnormalities Myocardial Infarction - surgery Prosthesis Design pseudoaneurysm reimplanted coronaries stentless Freestyle bioprosthesis Swine Treatment Outcome |
title | Structural abnormalities after aortic root replacement with stentless xenograft |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T15%3A10%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Structural%20abnormalities%20after%20aortic%20root%20replacement%20with%20stentless%20xenograft&rft.jtitle=The%20Journal%20of%20thoracic%20and%20cardiovascular%20surgery&rft.au=Dagneg%C3%A5rd,%20Hanna%20Sofia%20Holmgren&rft.date=2023-04&rft.volume=165&rft.issue=4&rft.spage=1285&rft.epage=1297.e6&rft.pages=1285-1297.e6&rft.issn=0022-5223&rft.eissn=1097-685X&rft_id=info:doi/10.1016/j.jtcvs.2021.04.087&rft_dat=%3Cproquest_cross%3E2540518036%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2540518036&rft_id=info:pmid/34116854&rft_els_id=S0022522321007923&rfr_iscdi=true |