Recurrent subaortic membrane removal with homograft explant.

Q4 Medicine

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-03-07 DOI:10.1510/mmcts.2025.004

Leah D'Silva, Omar A Jarral, Stevan Pupovac, Jui-Chuang Tseng, Nirav C Patel, S Jacob Scheinerman, Alan Hartman, Derek R Brinster

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Abstract

This 27-year-old female patient is undergoing a reoperation for a recurrent subaortic membrane causing significant left ventricular outflow obstruction. The re-sternotomy is uneventful and cardiopulmonary bypass is established. The left ventricular outflow tract is accessed through the previously implanted semi-calcified homograft aortic root. The fibrous tissue of the subaortic membrane is resected as a crescent, along with a septal myectomy. The aortic annulus and previous aortic homograft are resected to enlarge the aortic root from 12 mm to 21 mm. The left ventricular outflow tract is then reconstructed with pericardium, and a valved conduit aortic root replacement, size 21 mm Konect prosthesis, is implanted. The pericardium is closed with Gore-Tex membrane, should future surgery be needed. A 21-mm valve was considered adequate, given her height of 157 cm and low body surface area of 1.45 m2. This patient was not an appropriate candidate for a Ross-Konno procedure or a mechanical valve due to extremely challenging social circumstances, medical noncompliance and housing insecurity.

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来源期刊

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

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期刊介绍： The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.