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Aortic stenosis is the narrowing of the exit of the left ventricle of the heart, such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include shortness of breath especially when lying down, at night, or with exercise, and swelling of the legs. Thickening of the valve without causing obstruction is known as aortic sclerosis.
Aneurysm of the aortic sinus, also known as the sinus of Valsalva, is a rare abnormality of the aorta, the largest artery in the body. The aorta normally has three small pouches that sit directly above the aortic valve, and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left coronary sinus. These aneurysms may not cause any symptoms but if large can cause shortness of breath, palpitations or blackouts. Aortic sinus aneurysms can burst or rupture into adjacent cardiac chambers, which can lead to heart failure if untreated.
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax.
Aortic valve replacement is a procedure whereby the failing aortic valve of a patient's heart is replaced with an artificial heart valve. The aortic valve may need to be replaced because:
Sir Magdi Habib Yacoub is an Egyptian-British retired professor of cardiothoracic surgery at Imperial College London, best known for his early work in repairing heart valves with surgeon Donald Ross, adapting the Ross procedure, where the diseased aortic valve is replaced with the person's own pulmonary valve, devising the arterial switch operation (ASO) in transposition of the great arteries, and establishing the heart transplantation centre at Harefield Hospital in 1980 with a heart transplant for Derrick Morris, who at the time of his death was Europe's longest-surviving heart transplant recipient. Yacoub subsequently performed the UK's first combined heart and lung transplant in 1983.
Tirone Esperidiao David, is a Brazilian-born Canadian cardiac surgeon and professor of surgery at the University of Toronto. He is an attending cardiac surgeon at the Peter Munk Cardiac Centre, Toronto General Hospital. He is known for his 2007 development of a valve sparing aortic root replacement procedure to preserve the aortic valve in patients with aortic root aneurysms such as in Marfan syndrome; it is now known as the "David Operation".
Transcatheter aortic valve implantation (TAVI) is the implantation of the aortic valve of the heart through the blood vessels without actual removal of the native valve. The first TAVI was performed on 16 April 2002 by Alain Cribier, which became a new alternative in the management of high-risk patients with severe aortic stenosis. The implantated valve is delivered via one of several access methods: transfemoral, transapical, subclavian, direct aortic, and transcaval, among others.
David H. Adams is an American cardiac surgeon and the Marie-Josée and Henry R. Kravis Professor and Chairman of the Department of Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai Hospital in New York City. Dr. Adams is a recognized leader in the field of heart valve surgery and mitral valve reconstruction. As director of Mount Sinai Mitral Valve Repair Center, he has set national benchmarks with >99% degenerative mitral valve repair rates, while running one of the largest valve repair programs in the United States. Dr. Adams is the co-inventor of 2 mitral valve annuloplasty repair rings – the Carpentier-McCarthy-Adams IMR ETlogix Ring and the Carpentier-Edwards Physio II Annuloplasty Ring, and is a senior consultant with royalty agreements with Edwards Lifesciences. He is also the inventor of the Tri-Ad Adams Tricuspid Annuloplasty ring with a royalty agreement with Medtronic. He is a co-author with Professor Alain Carpentier of the benchmark textbook in mitral valve surgery Carpentier's Reconstructive Valve Surgery. He is also the National Co-Principal Investigator of the FDA pivotal trial of the Medtronic-CoreValve transcatheter aortic valve replacement device.
Randall Bertram Griepp was an American cardiothoracic surgeon who collaborated with Norman Shumway in the development of the first successful heart transplant procedures in the U.S. He had an international reputation for contributions to the surgical treatment of aortic aneurysms and aortic dissection and in heart and lung transplantations. He received nearly $8 million in grants from the National Heart, Lung, and Blood Institute.
Marian Ion Ionescu was a Romanian-born British cardiac surgeon. His interest in heart surgery covered several aspects of this specialty. He was an inventor of surgical devices, mostly artificial heart valves, a scientist in the broad term and a medical educator. Ionescu died on 12 October 2023, at the age of 94.
Lars Georg Svensson is a cardiac surgeon and the chairman of the heart and vascular institute at Cleveland Clinic. He is the Director of the Aorta Center, Director of the Marfan Syndrome and Connective Tissue Disorder Clinic, and is a professor of surgery at Cleveland Clinic Lerner College of Medicine and Case Western Reserve University. He is also the Director of Quality Outcomes and Process Improvement for the Department of Thoracic and Cardiovascular Surgery and Affiliate Cardiac Surgery Program at Cleveland Clinic.
A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional, more invasive surgical part with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy imaging in a hybrid operating room (OR) without interruption. The hybrid technique has a reduced risk of surgical complications and has shown decreased recovery time. It can be used to treat numerous heart diseases and conditions and with the increasing complexity of each case, the hybrid surgical technique is becoming more common.
Giuseppe Di Benedetto is an Italian cardiac surgeon born in Eboli on 8 January 1946, He holds the Italian national record for the use of carbon dioxide laser to perform revascularization trans-myocardial otherwise inoperable; specialized in congenital diseases of cardiovascular system, is one of the few surgeons in the world that practice successfully the surgery of aortic arch.
Nina Starr Braunwald was an American thoracic surgeon and medical researcher who was among the first women to perform open-heart surgery. She was also the first woman to be certified by the American Board of Thoracic Surgery, and the first to be elected to the American Association for Thoracic Surgery. In 1960, at the age of 32, she led the operative team at the U.S. National Institutes of Health (NIH) that implanted the first successful artificial mitral human heart valve replacement, which she had designed and fabricated.
Michael J. Reardon is an American cardiac surgeon and medical researcher. He is known for his work in heart autotransplantation for malignant heart tumors, an operation in which the surgeon removes the patient's heart, cuts out the malignant tumor, and reimplants the heart back in the patient's chest. He performed the first successful heart autotransplantation for a cancerous heart tumor in 1998.
Hans-Joachim Schäfers is a German surgeon, as well as cardiac, thoracic, and vascular surgeon and university professor. He is director of the department of Thoracic and Cardiovascular Surgery at the Saarland University Medical Center in Homburg/Saar, Germany. He is known for his activities in aortic valve repair, aortic surgery, and pulmonary endarterectomy.
Christoph Huber MD, FMH, FECTS is a Swiss cardiac surgeon who is a professor and the head of the Division of Cardiac and Vascular Surgery at the University Hospital Geneva, Switzerland.
The Yasui procedure is a pediatric heart operation used to bypass the left ventricular outflow tract (LVOT) that combines the aortic repair of the Norwood procedure and a shunt similar to that used in the Rastelli procedure in a single operation. It is used to repair defects that result in the physiology of hypoplastic left heart syndrome even though both ventricles are functioning normally. These defects are common in DiGeorge syndrome and include interrupted aortic arch and LVOT obstruction (IAA/LVOTO); aortic atresia-severe stenosis with ventricular septal defect (AA/VSD); and aortic atresia with interrupted aortic arch and aortopulmonary window. This procedure allows the surgeon to keep the left ventricle connected to the systemic circulation while using the pulmonary valve as its outflow valve, by connecting them through the ventricular septal defect. The Yasui procedure includes a modified Damus–Kaye–Stansel procedure to connect the aortic and pulmonary roots, allowing the coronary arteries to remain perfused. It was first described in 1987.
John D. Puskas is an American researcher, author, inventor and cardiovascular surgeon. As of 2022, he is Professor, Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, and chairman, Department of Cardiovascular Surgery at Mount Sinai Morningside, Mount Sinai Beth Israel and Mount Sinai West. He holds 11 U.S. patents and co-founded the International Coronary Congress and the International Society for Coronary Artery Surgery. He is credited by ResearchGate with 330 publications and 15,234 citations and as of 2022 Scopus reports an h-index of 62. Puskas is known for advancing coronary artery bypass (CABG) surgery by refining surgical techniques for all-arterial, off-pump CABG and inventing finer instruments to be used for advanced coronary bypass surgical procedures. He is credited with performing the first totally thoracoscopic bilateral pulmonary vein isolation procedure. He is the co-editor of State of the Art Surgical Coronary Revascularization, the first textbook solely devoted to coronary artery surgery.
Joseph E. Bavaria, M.D., FACS, FRCS (Edin) ad hom, is an American cardiothoracic surgeon a professor of surgery at the University of Pennsylvania and Director of its Thoracic Aortic Surgery Program. Bavaria is known as a leading figure in clinical trials for catheter-based aortic valve replacement (TAVR), thoracic aortic surgery, and aortic endograft procedures (TEVAR). He wrote more than 600 research papers and founded the Penn Aortic Center. Bavaria served as the 52nd president of the Society of Thoracic Surgeons (STS) from 2016 to 2017, the 3rd President of the Thoracic Surgery Foundation (TSF) (2019-2022), the Chairman of The Society of Thoracic Surgeons/ACC TVT Registry Steering Committee (2017-2020) and an International Councilor of the European Association for Cardio-Thoracic Surgery (EACTS) (2021-2024) Bavaria has performed more than 9,000 surgeries throughout his career as of 2019.
References
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- Joint public statement regarding Professor Marjan Jahangiri, Consultant Cardiac Surgeon. St George's Hospital , 20 May 2019