• A transthoracic echocardiogram (TTE) indicates if there is an aortic regurgitation, but a 3-D transesophageal echocardiogram can give a better view of the aortic valve. (wikipedia.org)
  • Congenital quadricuspid aortic valve associated with aortic insufficiency and mitral regurgitation. (wikipedia.org)
  • Quadricuspid aortic valve: a rare etiology of aortic regurgitation. (wikipedia.org)
  • They were evaluated using echocardiography and computed tomography in terms of mortality and reoperation according to their preoperative demographic characteristics, aortic regurgitation (AR), and annular dilatation levels. (kosuyoluheartjournal.com)
  • The reimplantation procedure applied in our clinic is thought to be advantageous in decreasing the risk of postoperative aortic regurgitation (AR) and aortic root dilation in patients with aortic dissection and Marfan syndrome. (kosuyoluheartjournal.com)
  • This backward flow through a valve is called regurgitation. (gh.ge)
  • Thourani concluded that the Trilogy system provides the first dedicated transcatheter aortic valve replacement options "for symptomatic patients with moderate to severe or severe aortic regurgitation or at high risk for surgery and is well positioned to become the preferred therapy upon approval for this population. (medscape.com)
  • Untreated, severe symptomatic aortic regurgitation (AR) is associated with high mortality, especially for those with NYHA class 3 or 4 symptoms, Thourani explained. (medscape.com)
  • Off-label use of transcatheter valves for AR has been associated with "higher rates of complications, including paravalvular regurgitation and embolization," he noted. (medscape.com)
  • Exclusion criteria included an aortic root diameter greater than 5 cm, a previous prosthetic aortic valve, mitral regurgitation greater than moderate, or coronary artery disease requiring revascularization. (medscape.com)
  • Mechanical behavior and collagen structure of degenerative mitral valve leaflets and a finite element model of primary mitral regurgitation. (uib.no)
  • Mitral Annular Elasticity Determines Severity of Regurgitation in Barlow's Mitral Valve Disease. (uib.no)
  • Left Ventricular Contraction Pattern in Chronic Aortic Regurgitation and Preserved Ejection Fraction: Simultaneous Stress-Strain Analysis by Three-Dimensional Echocardiography. (uib.no)
  • Exercise capacity and peak oxygen consumption in asymptomatic patients with chronic aortic regurgitation. (uib.no)
  • Controlled release metoprolol for aortic regurgitation: a randomised clinical trial. (uib.no)
  • Quantification of aortic regurgitation using high-pulse repetition frequency three-dimensional colour Doppler. (uib.no)
  • Aortic regurgitation can occur when the aortic annulus is poorly shaped, not letting the valve's leaflets come together properly. (medgadget.com)
  • The maximum and mean AV gradient, the effective orifice area (EOA) (Figure 3), aortic regurgitation (AR) degree, including structural, Doppler, quantitative and qualitative parameters recommended by the American Society of Echocardiography [4], was assessed. (scardio.ru)
  • Mitral valve disease is a common valvular heart disease, which includes mitral stenosis, mitral regurgitation and the combination of both conditions. (biomedcentral.com)
  • Patients with more than moderate aortic regurgitation, a history of right chest surgery or chest irradiation, severe aortoiliac stenotic diseases and prior cardiac surgery were excluded. (biomedcentral.com)
  • Regurgitation happens when the valve fails to close adequately, allowing the blood to leak backward and disrupting the normal one-directional blood flow in the heart. (doctorable.com)
  • Mitral valve regurgitation: in mitral valve regurgitation the blood flows backward from the left ventricle into the left atrium. (doctorable.com)
  • Aortic valve regurgitation: aortic valve regurgitation occurs when the aortic valve fails to close properly during diastole, which causes the blood to flow backward from the aorta into the left ventricle. (doctorable.com)
  • Tricuspid valve regurgitation: this occurs when the tricuspid valve does not close properly, allowing blood to leak back from the right ventricle to the right atrium. (doctorable.com)
  • Pulmonary valve regurgitation: when the pulmonary valve does not close adequately, blood from the pulmonary arteries flows back into the right ventricle, impeding the appropriate gas exchange and leading to Pulmonary Hypertension. (doctorable.com)
  • Valvular prolapse happens when the leaflets slip out of place in heart systole, which leads to improper closure of the valves and the subsequent disruption of normal blood flow, which can produce blood regurgitation. (doctorable.com)
  • Furthermore, the damage to the valve can cause stenosis or regurgitation , and both can occur in the same valve. (symptoma.com)
  • Myxomatous mitral valve disease (MMVD) is the most prevalent cardiac disease in dogs and is characterized by a slow, progressive myxomatous degeneration of the mitral valve leaflets, leading to mitral valve regurgitation (MR) of increasing severity and subsequent left atrial (LA) and left ventricular (LV) dilatation ( Ljungvall and Häggström, 2016 ). (openveterinaryjournal.com)
  • An abnormality of the mitral leaflets, mitral annulus, chordae tendineae, papillary muscles, left atrium, or left ventricle can lead to mitral regurgitation. (doctorlib.info)
  • Endocarditis (infection on the heart valve) - a serious condition that can cause stenosis, regurgitation, sepsis, thrombosis or embolism (particles flying off into the blood stream) or abscesses (aggressive cavities of infection that eat away at healthy tissue). (lhch.nhs.uk)
  • Mitral regurgitation is where the mitral valve does not close properly as the blood is being ejected out of the left ventricle and forwards to the body through the aorta. (lhch.nhs.uk)
  • Rheumatic disease is associated with a thickened valve with reduced mobility and often a mixed picture of stenosis and regurgitation. (health.am)
  • In developed countries, more common causes of mitral regurgitation include myxomatous degeneration (eg, mitral valve prolapse with or without connective tissue diseases such as Marfan's syndrome), infective endocarditis, and subvalvular dysfunction (due to papillary muscle dysfunction or ruptured chordae tendineae). (health.am)
  • Nonrheumatic mitral regurgitation may develop abruptly, such as with papillary muscle dysfunction following myocardial infarction , valve perforation in infective endocarditis, or ruptured chordae tendineae in mitral valve prolapse. (health.am)
  • In acute mitral regurgitation, patients are in sinus rhythm rather than atrial fibrillation and have little or no enlargement of the left atrium, no calcification of the mitral valve, no associated mitral stenosis , and in many cases little left ventricular dilation. (health.am)
  • The major decision in treating aortic valve regurgitation is whether to have aortic valve replacement surgery and, if so, when to do it. (healthlinkbc.ca)
  • Valve surgery is usually only done if regurgitation is severe and in danger of doing irreparable damage to your heart. (healthlinkbc.ca)
  • The severity of aortic valve regurgitation. (healthlinkbc.ca)
  • The faster the regurgitation progresses, the sooner you will need a valve replacement. (healthlinkbc.ca)
  • But if you have other compounding factors, such as high blood pressure and coronary artery disease, the regurgitation is more likely to get worse soon, and surgery may be needed sooner. (healthlinkbc.ca)
  • The severity of regurgitation and the likelihood it will get worse need to be balanced against the risks involved with having a valve replacement surgery. (healthlinkbc.ca)
  • In the next slide you can see that there is, perhaps, moderate aortic insufficiency and moderate mitral regurgitation, as well. (medscape.com)
  • Although these biologic valves do not require anticoagulation, they do not allow growth, and their durability in the pediatric population is very limited due to the high risk of accelerated structural valve degeneration and early calcification. (medscape.com)
  • Investigations for myocardial infarction and calcification of the aortic valve annulus were negative (i.e., no elevation in cardiac enzymes, and normal chest radiography and transthoracic echocardiography). (cmaj.ca)
  • Acquired stenosis of the aortic valve, which affects adults, is most often caused by calcification of the leaflets themselves and is considered an age-related or degenerative process. (medscape.com)
  • Hardening of the aortic valve, usually by degenerative calcification, with a jet velocity of less than 5 mm/second is considered aortic sclerosis and is asymptomatic. (medscape.com)
  • At present, the most common cause of valve replacement in the United States is aortic stenosis secondary to calcification. (medscape.com)
  • With age, heart valves may accumulate deposits of calcium (aortic valve calcification). (gh.ge)
  • Cardiac calcification is a broad term for any calcification affecting the valves, coronary arteries , aortic root , endocardium, myocardium, and/or pericardium. (radiopaedia.org)
  • CCTA offers a 'one stop shop' investigation prior to TAVI (transcatheter aortic valve implantation), including aortic annulus size, calcification and anatomy, procedure approach be it transfemoral or transapical and even rules out significant coronary stenosis. (internationaldayofradiology.com)
  • Chest X-ray shows left atrial and ventricular enlargement, enlarged pulmonary arteries, and mitral valve calcification. (doctorlib.info)
  • Echocardiography reveals left atrial and ventricular enlargement, enlarged pulmonary arteries, and mitral valve calcification. (doctorlib.info)
  • Calcification of the mitral valve is less common than in pure mitral stenosis . (health.am)
  • Our group has previously demonstrated that, in a patient with systemic lupus erythematosus-associated AS (where the pathology was leaflet thickening without valve calcification), a SAPIEN XT valve (Edwards Lifesciences, Irvine, CA, USA) was implanted in a stable position12. (heartvascularcentre.com)
  • Due to her high surgical risk, TAVI was chosen as the preferred treatment option by the local Heart Team despite a lack of leaflet or annular calcification, and a SAPIEN 3 valve (Edwards Lifesciences) was successfully implanted without paravalvular leak and with satisfactory valve function at six months. (heartvascularcentre.com)
  • Reports exist of calcification and stenosis of the aortic annulus leading to coronary artery disease, and the risk of myocardial infarction is higher than normal in older patients with ochronosis. (medscape.com)
  • Again, note some calcification of the mitral chordae and thickening of the mitral valve. (medscape.com)
  • Enlargement of the mitral annulus and left ventricular cavity produce mitral valvular insufficiency. (justia.com)
  • Although mitral valve repair and replacement can successfully treat many patients with mitral valvular insufficiency, techniques currently in use are attended by significant morbidity and mortality. (justia.com)
  • In the present study, the effects of preoperative diagnosis, aortic insufficiency degree, surgical technique, simultaneous procedures, and the graft material used on mortality and reoperation were examined using 1, 6, and 12-month echocardiography and computed tomography (CT) scans of the patients. (kosuyoluheartjournal.com)
  • Postoperative echocardiography demonstrated absent to mild aortic insufficiency in 63 patients. (elsevierpure.com)
  • Eleven patients (21.2%) repaired by the implantation technique required aortic valve replacement secondary to aortic valve insufficiency. (elsevierpure.com)
  • Echo showed severe mitral insufficiency with mitral valve leaflet restriction. (ctsnet.org)
  • The surface echocardiogram was followed by a transesophageal echocardiogram (TEE) that confirmed the former and identified mild-to-moderate aortic insufficiency but, again, could not identify a vegetation nor any obvious complication of infective endocarditis (IE). (acc.org)
  • Do you notice that in both of the Dopplers the pulmonic-insufficiency (PI) and aortic-insufficiency (AI) jets have very steep descents with a lot of early filling happening in early diastole, suggesting the very rapid rise in the diastolic pressure of both the RV and the LV. (medscape.com)
  • After Trilogy valve implantation, patients were followed for 1, 6, and 12 months, and annually out to 5 years. (medscape.com)
  • Implantation is accomplished through placement of nine annular sutures that position the device under the annulus and away from the valve leaflets. (medgadget.com)
  • Transcatheter aortic valve implantation (TAVI) is a well-recognized and established therapy for severe aortic stenosis, with expanding indications toward younger patients with low surgical risk profile. (frontiersin.org)
  • Transcatheter aortic valve implantation (TAVI) has been widely recognized as a safe and effective treatment for aortic stenosis (AS) in patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high or intermediate surgical risk ( 1 - 4 ). (frontiersin.org)
  • Each year, approximately 9,000 diagnostic and therapeutic procedures are performed in the catheter lab, pioneering in the clinical use of cutting-edge interventional cardiac procedures, such as Transaortic Valve Implantation (TAVI), MitraClip, magnet guided radiofrequency ablation. (z2hospital.com)
  • Transcatheter aortic valve implantation in rheumatic aortic stenosis. (heartvascularcentre.com)
  • Transcatheter aortic valve implantation (TAVI) has become an established treatment for patients with severe aortic valve stenosis (AS) who are inoperable or at high surgical risk1-6, and an attractive alternative in intermediate surgical-risk patients7,8. (heartvascularcentre.com)
  • This report summarises some key sessions on transcatheter aortic valve implantation (TAVI), valve-in-valve (ViV) interventions and optimisation of such procedures. (hospitalhealthcare.com)
  • Nancy & Bill Thompson Heart Valve Center is one of a handful of clinics nationwide dedicated to state-of-the-art screening, diagnosis, and treatment of valvular heart disease. (hoag.org)
  • Hoag's world-renowned valvular heart disease program continues to lead the way in advanced cardiac care. (hoag.org)
  • The team first mapped valvular heart disease by examining 140,000 patients, and identified a new mutation in ADAMTS5 that causes bicuspid aortic valve-associated aortic stenosis. (z2hospital.com)
  • Valvular heart disease refers to a collection of disorders that produce a malfunctioning of any of the anatomical structures of the heart valves, namely the aortic valve, the mitral valve, the pulmonary valve, and/or the tricuspid valve. (doctorable.com)
  • The causes of valvular heart disease depend upon the underlying etiology, which could be acquired or congenital. (doctorable.com)
  • Patients with valvular heart disease may complain of dyspnea, chest pain, palpitations, and syncope, along with a variety of findings on the physical examination. (doctorable.com)
  • Valvular heart disease (VHD) alludes to any condition where there is a structural or functional abnormality in the leaflets, annulus, papillary muscles, or chordae tendineae of one or more of the four heart valves, namely the tricuspid, mitral, aortic, and pulmonary valves. (doctorable.com)
  • When more than one heart valve is affected, the condition is termed multiple valvular heart disease. (doctorable.com)
  • Valvular heart disease is characterized by a defect or deterioration of one of the valves. (symptoma.com)
  • It is the most common valvular heart disease of the elderly and increases with age. (3dprint.com)
  • The causes of valvular heart disease are varied and differ for each type of valve disorder. (doctorlib.info)
  • Pathophysiology of valvular heart disease varies according to the valve and the disorder. (doctorlib.info)
  • Cardiac catheterization, chest X-ray, echocardiography, and electrocardiography are the standard diagnostic tools used to detect valvular heart disease. (doctorlib.info)
  • 2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. (healthlinkbc.ca)
  • Quadricuspid aortic valves are very rare cardiac valvular anomalies with a prevalence of 0.013% to 0.043% of cardiac cases and a prevalence of 1 in 6000 patients that undertake aortic valve surgery. (wikipedia.org)
  • Comprehensive assessment of a quadricuspid aortic valve and coronary arteries by multidetector cardiac CT. (wikipedia.org)
  • As one of the highest-volume surgical programs in the country, Nancy & Bill Thompson Heart Valve Center's expert cardiac surgery team is well-versed in the full array of aortic valve surgical options, including complex surgical procedures not available at other centers. (hoag.org)
  • With advances in modern surgical techniques, cardiac surgeons now have multiple methods to replace the aortic valve using innovative new prosthetic options. (hoag.org)
  • This enables assessment of the size of the cardiac chambers, detection of any mitral and aortic valve disease, Doppler echocardiography of the mitral annulus and of the LV outflow tract of the left ventricle (calculation of cardiac flow). (uness.fr)
  • Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, affecting 1-2% of the population, and is the cause of a significant proportion of aortic valve disease in young adults ( 9 ). (frontiersin.org)
  • Could you please give a detailed overview of when and for which diseases you use cardiac imaging? (internationaldayofradiology.com)
  • Congenital heart disease utilises CMR routinely for cardiac function, shunt quantification, valve assessment and anatomical delineation. (internationaldayofradiology.com)
  • One of the signature annual conferences, China Valve (Hangzhou), attracted 1,500 attendees and nearly 840,000 online views from China and another 22 countries and regions in 2021, with its broad coverage of academic topics and live demonstration of cardiac procedures. (z2hospital.com)
  • Despite minimally-invasive aortic valve replacement (MI-AVR) having gained interest within the cardiac surgeons' community, patient requests for interventions associated with minimized trauma and faster recovery often remains unfulfilled ( 1 ). (annalscts.com)
  • The advent of three-dimensional echocardiography (3D echo) has increased the clinical impact of non-invasive imaging and significantly improved our understanding and management of cardiac diseases. (unipd.it)
  • The availability of unprecedented views of heart valves and cardiac chambers from any perspective in the beating heart provides valuable clinical information and new levels of confidence in diagnosing heart diseases. (unipd.it)
  • Due to the previous sternotomies, longstanding cardiac disease and advancing age, many of these patients will be at elevated risk for aortic valve replacement. (heartvascularcentre.com)
  • Prothesis-patient mismatch (PPM) occurs when there is a mismatch between the effective orifice area (EOA) of the prosthetic valve and the required cardiac output to meet the need of the patient's body surface area (BSA). (ochsner.org)
  • A large study called the Second Natural History Study of Congenital Heart Defects analyzed the treatment, quality of life, echocardiography findings, complications, exercise responses, and predisposition to endocarditis with regards to cardiac valvular disease, and pulmonary stenosis was found to be the most benign valvular lesion. (medscape.com)
  • Through a poorly understood process, the cardiac jelly goes through local expansion and bolus swelling, and cardiac valves are formed. (medscape.com)
  • A gradient of between 20 and 40 mm Hg is considered moderate, and more than 40 mm Hg severe aortic stenosis, according to American Heart Association guidelines. (medscape.com)
  • Patients with severe calcific degenerative aortic stenosis can be categorized into three clinical groups at the time of diagnosis: those without evidence of congestive heart failure, those with chronic congestive heart failure, and those with acute heart failure requiring hospitalization. (medscape.com)
  • If you have severe aortic valve stenosis, you'll usually need surgery to replace the valve. (gh.ge)
  • Aortic valve stenosis ranges from mild to severe. (gh.ge)
  • High-molecular-weight von Willebrand Factor multimer ratio differentiates true-severe from pseudo-severe classical low-flow, low-gradient aortic stenosis. (uib.no)
  • This condition reduces the amount of blood that can flow through the valve and, in severe cases, it may eventually lead to systemic hemodynamic alterations. (doctorable.com)
  • Before outlining their final plan, a pre-operative evaluation team at the Second Affiliated Hospital of Nanchang University , in China's Jiangxi Province, relied on 3D printing to simulate a transcatheter aortic valve replacement (TAVR) surgery on a high-risk elderly patient with severe aortic valve stenosis. (3dprint.com)
  • In China, the prevalence of moderate or severe aortic stenosis in patients more than 75 years old is over two percent. (3dprint.com)
  • The patient was an 80-year-old-male presenting with NYHA-III symptoms due to his severe aortic valve stenosis. (annalscts.com)
  • Results:About half of 17 patients(48.6%)were assigned to open repair and as many as 14 of them(82.4%)were excluded from the indication of endovascular treatment due to anatomical unsuitability, which included an extremely short proximal neck, severe aortic elongation and access route problems. (or.jp)
  • In their report, Gunasekaran et al16 describe a 70-year-old lady with mitral valve surgery on two previous occasions and severe comorbidities, presenting with symptomatic severe rheumatic AS. (heartvascularcentre.com)
  • Infective endocarditis as a cause of AV disease was diagnosed in 23 (3.2%) patients. (scardio.ru)
  • Our patient was subsequently diagnosed with acute aortic valve endocarditis on a native aortic valve that was complicated by both an aortic root abscess and a contained aortic root rupture, leading to hemorrhagic pericarditis. (acc.org)
  • Other valve repair techniques in current use include commissurotomy (cutting the valve commissures to separate fused valve leaflets), shortening mitral or tricuspid valve chordae tendonae, reattachment of severed mitral or tricuspid valve chordae tendonae or papillary muscle tissue, and decalcification of the valve leaflets or annulus. (justia.com)
  • Postrheumatic aortic stenosis is another common cause of acquired aortic stenosis, and is a result of remote infection from group A streptococci that triggers an autoimmune process resulting in scarring of the valve leaflets. (medscape.com)
  • Congenital heart defect .The aortic valve consists of three tightly fitting, triangular-shaped flaps of tissue called leaflets. (gh.ge)
  • Some children are born with an aortic valve that has only one (unicuspid), two (bicuspid) or four (quadricuspid) leaflets - not three. (gh.ge)
  • As blood repeatedly flows over the aortic valve, deposits of calcium can accumulate on the valve's leaflets. (gh.ge)
  • However, in some people - particularly those with a congenitally abnormal aortic valve, such as a bicuspid aortic valve - calcium deposits result in stiffening of the leaflets of the valve. (gh.ge)
  • The aortic valve - your heart's gateway to the aorta - consists of three tightly fitting, triangular-shaped flaps of tissue called leaflets. (gh.ge)
  • These leaflets connect to the aorta via a ring called the annulus. (gh.ge)
  • The leaflets of the aortic valve are forced open as the left ventricle contracts and blood flows into the aorta. (gh.ge)
  • When all of the left ventricular blood has gone through the valve and the left ventricle has relaxed, the leaflets swing closed to prevent the blood that has just passed into the aorta from flowing back into the left ventricle. (gh.ge)
  • The system has a set of three "locators" in its own sheath that allows it to be rotated to align with the three cusps of the native aortic valve, falling into the sinuses and securely anchored to the native valve leaflets, and then the valve is deployed. (medscape.com)
  • The HAART 300 device is used to reshape and stabilize the aortic annulus so that the natural valve leaflets close properly, preventing blood from flowing in reverse through the aorta. (medgadget.com)
  • Mitral valve prolapse: mitral valve prolapse happens when the valve leaflets bulge into the atrium during systole, thus allowing blood to flow backward (regurgitate). (doctorable.com)
  • The anterior leaflet was divided in the A2 segment, and mitral valve replacement was performed with the preservation of both mitral valve leaflets. (ctsnet.org)
  • The leaflets are like the doors themselves, the annulus is like the doorframe and the subvalvar apparatus are like door restrictors. (lhch.nhs.uk)
  • During left ventricular systole, the mitral leaflets do not close normally, and blood is ejected into the left atrium as well as through the aortic valve. (health.am)
  • While postoperative AR was seen in one patient with Takayasu's arteritis (n= 1, 4.16%), it was not observed in the patients with Marfan syndrome or bicuspid aortic valve disease. (kosuyoluheartjournal.com)
  • As bicuspid aortic valve (BAV) affects ~1-2% of the population, it may be speculated that an increasing number of patients with degenerated BAV may eventually need TAVI during the course of the disease. (frontiersin.org)
  • A quadricuspid aortic valve (QAV) is a rare congenital heart defect characterized by the presence of four cusps, instead of the usual three found normally in the aortic valve. (wikipedia.org)
  • Apart from rare congenital anomalies (birth defects), CAD is usually a degenerative disease, uncommon as a clinical problem before the age of 30 years and common by the age of 60 years. (medscape.com)
  • Aortic stenosis can be caused by acquired conditions, be the result of a congenital malformation, or be a result of a combination of acquired and congenital processes. (medscape.com)
  • Congenital aortic stenosis is classified as valvular, subvalvular, and supravalvular. (medscape.com)
  • Congenital aortic stenosis becomes symptomatic in childhood. (medscape.com)
  • Bicuspid and unicuspid aortic valve disease are congenital conditions. (medscape.com)
  • Some of the common indications for CCTA include ruling out coronary artery disease, ventricular thrombus delineation, post-bypass graft evaluation and congenital heart disease. (internationaldayofradiology.com)
  • Патофізіологія Congenital heart disease is the most common congenital anomaly, occurring in almost 1% of live births ( 1). (msdmanuals.com)
  • Among birth defects, congenital heart disease is the leading cause of infant mortality. (msdmanuals.com)
  • It is usually an isolated lesion and occurs in up to 12% of congenital heart disease (CHD). (medscape.com)
  • Lower, Stofer, and Shumway investigated the concept in 1960 using autotransplantation of the pulmonic valve into the descending thoracic aorta of dogs. (medscape.com)
  • Bentall with Bioprosthesis is a replacement of the aortic valve, root, and the entire ascending aorta, utilizing a graft. (hoag.org)
  • It is also indicated whenever there is a combined dilation of the aortic root and annulus, as well as the ascending aorta. (hoag.org)
  • During a Porcine Root Replacement, the aortic root is replaced with a preserved pig aorta. (hoag.org)
  • This can be a reasonable replacement for the same indications as a homograft, as well as for a replacement of a short segment of aorta (aortic root). (hoag.org)
  • This narrowing prevents the valve from opening fully, which obstructs blood flow from your heart into your aorta and onward to the rest of your body. (gh.ge)
  • With each heartbeat, the left ventricle forces blood through the aortic valve into the aorta, your body's largest artery. (gh.ge)
  • Aortic valve stenosis: if the aortic valve gets narrowed, the blood that flows through the aorta from the heart to the rest of the body gets restricted, thus requiring the left ventricle to contract harder to compensate. (doctorable.com)
  • After ECC institution, a minimally-invasive clamp (Cygnet ® Flexible Clamps, Vitalitec, USA) was applied across the distal ascending aorta, and warm blood cardioplegia was given through the aortic root A "hockey-stick" aortotomy crossing the sinotubular junction was performed and the aortic valve exposed. (annalscts.com)
  • range: 21-81 years) underwent aortic root reconstruction with preservation of the aortic valve and replacement of ascending aorta. (elsevierpure.com)
  • Next, an aortic clamp was put through the second ICS, and the aorta was cross-clamped under direct vision. (ctsnet.org)
  • However, the presence of comorbidities is related to high mortality because it necessitates urgent and complicated surgery for patients with aortic dissection. (kosuyoluheartjournal.com)
  • Computed tomography scanning was applied in all patients in the pre-and postoperative periods to assess aortic diameters, blood flow, and thrombosis in the true and false lumen in cases of aortic dissection. (kosuyoluheartjournal.com)
  • TEE clearly demonstrated the Intimal tear which can technically be termed an aortic dissection. (valvereplacement.org)
  • For these peculiarities and the higher rates of paravalvular leak (PVL), new permanent pacemaker (PPM), need for a second transcatheter heart valve (THV), risk of annulus rupture or aortic dissection, and brain injury ( 13 - 15 ) BAV patients have been initially excluded from the randomized trials. (frontiersin.org)
  • Other indications include 'triple rule out' for ruling out aortic dissection, pulmonary embolism and coronary disease. (internationaldayofradiology.com)
  • Only among the EVAR patients, aortic related death occurred in 1 patient(5.6%), which was acute type A aortic dissection. (or.jp)
  • Various surgical techniques have been developed to repair a diseased or damaged valve. (justia.com)
  • The goal of the trial was to assess the safety and efficacy of transcatheter aortic valve replacement (TAVR) with the self-expanding CoreValve compared with surgical AVR (SAVR) in intermediate-risk patients. (acc.org)
  • For patients with aortic root aneurysms, elective VSARR is a good surgical option. (kosuyoluheartjournal.com)
  • Aortic root replacement with a composite graft is the traditional surgical technique for aortic root aneurysms( 1 ). (kosuyoluheartjournal.com)
  • This revolutionary non-surgical option utilizes a catheter to replace the damaged aortic valve. (hoag.org)
  • ALIGN-AR was a multicenter, single arm, non-blinded trial with follow-up out to 5 years involving patients with 3-plus or greater AR at high risk for surgical aortic valve replacement . (medscape.com)
  • However, when the progression of the disease is slow, SAVR may be required in older age groups at higher surgical risk due to the age itself and coexistent comorbidities ( 10 , 11 ). (frontiersin.org)
  • 12 mm/m2 by CT, continues to be one of the greatest challenges of both surgical and endovascular aortic valve treatments. (solaci.org)
  • As reported by the Second Affiliated Hospital , to treat the condition, surgeons usually perform a thoracotomy aortic valve replacement, but for the elderly and people with other serious underlying diseases, the surgical risk is much greater than the risk of the disease itself. (3dprint.com)
  • At the Lancisi Cardiovascular Center, we currently use three surgical minimally-invasive approaches to expose and replace the aortic valve: the ministernotomy, the anterior right minithoracotomy, and the trans-axillary approach. (annalscts.com)
  • The CE mark and the FDA approval of Medtronic's new Avalus pericardial aortic surgical valve, which helps in treating aortic valve disease, have driven the global prosthetic heart valves market. (technavio.com)
  • The launch of the Avalus valve helped Medtronic to remain the market leader as it is the only MRI-safe stented surgical aortic valve available in the market. (technavio.com)
  • Objective:The availability of endovascular aneurysm repair(EVAR)has gradually increased the number of patients undergoing surgical treatment for ruptured abdominal aortic aneurysm(rAAA). (or.jp)
  • As with the global experience, TAVI has been increasingly applied in Asia to off-label indications such as bicuspid AS10, degenerated surgical bioprosthesis (valve-in-valve TAVI)11, non-calcific AS12, and pure aortic regurgitation13. (heartvascularcentre.com)
  • 1 Dr. Parma explained this is likely due to increasing comorbidities in patients, resulting in contraindications to anticoagulants, and further predicts that, in the majority of countries, the number of TAVI procedures will soon exceed those of surgical aortic valve replacement (SAVR). (hospitalhealthcare.com)
  • On behalf of the patients and caregivers in our community, I want to extend a special thanks to Dr. McCarthy for taking time out of his busy schedule to educate our patient and caregiver community about tricuspid valve disease and the surgical approaches to cure this disorder. (heart-valve-surgery.com)
  • There are cases that lead to a prosthesis-patient mismatch after AV replacement with both mechanical and biological prosthe- ses, especially in patients with a small aortic annulus (AA) [1]. (scardio.ru)
  • Strategies to mitigate the risk of PPM such as aortic root replacement in patients with the small aortic annulus should be utilized. (ochsner.org)
  • The fourth dysplastic cusp is incapable of fully closing the aortic annulus, which causes a backflow of blood through the aortic valve. (wikipedia.org)
  • One of the concerns of using TAVI in such patients is whether the transcatheter heart valve can be well anchored. (heartvascularcentre.com)
  • The procedure of replacing the aortic valve with the patient's own pulmonary valve and then using a pulmonary allograft to replace the pulmonary valve is commonly referred to as the Ross procedure. (medscape.com)
  • CCTA offers structural assessment prior to pulmonary vein isolation, left atrial appendage occlusion insertion, mitral valve procedures and TAVI procedure. (internationaldayofradiology.com)
  • Pulmonary valve stenosis: narrowing of the pulmonary valve impairs the blood flow from the right ventricle to the lungs through the pulmonary arteries. (doctorable.com)
  • Aortic, tricuspid, and pulmonary valve prolapse: prolapse in these valves happen less frequently than in the mitral valve, but the mechanism is the same, and normal one-direction blood flow in the heart gets disrupted. (doctorable.com)
  • The pulmonary annulus and the right ventricular outflow tract (RVOT) may be narrowed as well. (medscape.com)
  • See also Aortic Stenosis , Pediatric Valvar Aortic Stenosis , Pediatric Rheumatic Heart Disease , and Pathology of Rheumatic Heart Disease . (medscape.com)
  • A complication of strep throat infection, rheumatic fever may result in scar tissue forming on the aortic valve. (gh.ge)
  • Rheumatic fever may damage more than one heart valve, and in more than one way. (gh.ge)
  • Finally, the aortic valve was found to be heavily calcified by what was most likely rheumatic disease, upon which vegetations were identified. (acc.org)
  • By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. (health.am)
  • Rheumatic heart disease (RHD), although declining in incidence over the past few decades, is still relatively prevalent in many parts of Asia. (heartvascularcentre.com)
  • It is not uncommon for patients with rheumatic AS to have had several episodes of heart valve surgery for mitral and tricuspid valve pathologies. (heartvascularcentre.com)
  • As rheumatic AS involves a similar pathology to that of leaflet thickening and fibrosis, it is likely that a transcatheter valve could be successfully anchored. (heartvascularcentre.com)
  • As the benefit-risk ratio of TAVI in rheumatic AS becomes more favourable, TAVI may become the first treatment choice for many patients with RHD who have undergone various interventions for mitral or tricuspid disease. (heartvascularcentre.com)
  • What is the exact mechanism of the transcatheter valve expansion when deployed within a rheumatic AS, and what is the durability of TAVI in these rheumatic patients who are generally younger and may still have an ongoing low grade inflammatory response? (heartvascularcentre.com)
  • Then the coronary arteries are implanted in the graft using aortic buttons. (hoag.org)
  • In addition, the proportion of aortic valves with bicuspid morphology and small annulus (≤ 21 mm) was 28% and 38.9%, respectively. (authorea.com)
  • An unusual cause of prosthetic aortic valve thrombosis detected by multimodality imaging. (uib.no)
  • eventually, patients require reoperation and possible valve replacement. (medscape.com)
  • Nevertheless, aortic valve repair delays ultimate replacement until alternative valve replacement options can be offered to patients after completion of somatic growth, pregnancy and increased compliance with anticoagulation regimen. (medscape.com)
  • Mid-term results in patients having tricuspidization of the quadricuspid aortic valve. (wikipedia.org)
  • According to recent estimates, more than 79,000 patients are diagnosed with aortic and mitral valve disease in U.S. hospitals each year. (justia.com)
  • Between June 2017 and December 2019, 72 patients diagnosed with isolated aortic valve disease, with a mean age of 52.9 (19 - 79 years old), and a male:female ratio of 3:1 underwent aortic valve reconstruction surgery by Ozaki's technique at Cardiovascular Center, E Hospital, Vietnam. (authorea.com)
  • The mean aortic cross-clamp time was 106 ± 13.8 minutes, mean cardiopulmonary bypass time was 136.7 ± 18.5 minutes, and 2.8% of all patients required conversion to prosthetic valve replacement surgery. (authorea.com)
  • Mitral valve prolapse (MVP) is associated with aortic root (AoR) enlargement in patients with inherited connective tissue disorders. (researchgate.net)
  • In this study, we retrospectively analyzed the mid-term outcomes of patients who underwent aortic valve-sparing root replacement (VSARR). (kosuyoluheartjournal.com)
  • Preservation of native aortic valve tissue provides an advantage in reducing thromboembolic and hemorrhagic complications associated with mechanical valves and reoperations due to bioprosthesis degeneration, especially in young patients( 4 , 5 ). (kosuyoluheartjournal.com)
  • For some patients with aortic valve disease, conventional surgery is not an option. (hoag.org)
  • Aortic sclerosis, which is clinically defined as valve thickening without obstruction to outflow, is the most prevalent valve disease in developed countries, being present in about 25% of patients over age 65 years. (medscape.com)
  • Peculiar features such as larger dimensions of the aortic valve components, higher calcium burden, presence of a heavily calcified raphe, and associated aortopathy represent some pitfalls when treating BAV patients with TAVI. (frontiersin.org)
  • We performed the retro-prospective multicenter study of patients with AV disease selected for the Ozaki procedure. (scardio.ru)
  • The most common causes of AV dysfunction were aortic stenosis - 496 (68,6%) patients, AR - 44 (6%), aortic stenosis and AR - 184 (25,4%) patients. (scardio.ru)
  • Based on further research in epidemiology, genetics, and pathogenesis, the team then developed the Hangzhou Solution, a comprehensive solution of transcatheter aortic valve replacement that specifically accommodates Chinese heart valvular disease patients. (z2hospital.com)
  • This systematic approach allows a cardiologist to choose valve size according to patients' supravalvular annulus structure. (z2hospital.com)
  • The team went on to develop the first Chinese-designed and innovated retrievable and navigable artificial heart valve, the VenusA-Plus, which has been successfully implanted in patients in over 100 medical centers in South America, Europe, and Asia. (z2hospital.com)
  • From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. (biomedcentral.com)
  • From January 2018 to December 2019, we investigated all patients undergoing minimally invasive mitral valve replacement via a right minithoracotomy at the University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam. (biomedcentral.com)
  • The BEST study was a prospective, randomized study to compare percutaneous coronary intervention (PCI) with everolimus-eluting stents vs. myocardial revascularization surgery (MRS) in patients with multivessel disease. (solaci.org)
  • In patients with aortic valve stenosis, the severity of the condition increases gradually over the course of the years, which leads to the development of left ventricular concentric hypertrophy. (doctorable.com)
  • Assessment of left ventricular diastolic function is useful in risk stratification for patients with cardiovascular disease and can provide a diagnostic clue for heart failure with preserved ejection fraction. (medsci.org)
  • This technologically innovative device with advanced features improves clinical performance in aortic valve replacement patients. (technavio.com)
  • Background - The Ross procedure is commonly used to treat aortic valve disease in pediatric and adult patients. (elsevierpure.com)
  • 3 On this basis, Dr. Parma suggested that the future for primary SAVR patients may be TAVI-in-SAVR instead of reoperation, meaning consideration of the initial valve type and its failure, in regard to the patient's anatomy, is key. (hospitalhealthcare.com)
  • Finally, Dr. Parma discussed the difficulties of future coronary artery disease (CAD) in younger, low-risk patients. (hospitalhealthcare.com)
  • The most common sites of IE in hemodialysis patients are the mitral valve and aortic valve. (sch.ac.kr)
  • You may have noticed that most patients in our community have been diagnosed with an aortic or mitral valve disorder. (heart-valve-surgery.com)
  • Recently, however, I've been contacted by several patients who have tricuspid valve defects. (heart-valve-surgery.com)
  • As the tricuspid valve is often called the "forgotten valve" in medical literature, I wanted to help all patients learn more about the rise of tricuspid valve surgery. (heart-valve-surgery.com)
  • I'm doing very early stage patients and the valve is leaking for a different reason. (heart-valve-surgery.com)
  • There is a subgroup of patients that are not very common, but we're seeing those more too, where all the other valves are working fine and the only problem they have is a leaky tricuspid valve. (heart-valve-surgery.com)
  • Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. (nih.gov)
  • Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. (health.am)
  • There is no correlation between the anatomy and functional status of the aortic cusps. (wikipedia.org)
  • The aortic cusps were removed and the annulus decalcified. (annalscts.com)
  • Repeat TEE was significant for a thickened aortic root, along the posterior, medial, and anterior aspects, but once again failed to identify a vegetation on the aortic valve cusps (Video 3). (acc.org)
  • The swellings are normally hollowed out and reshaped to form the three thin-walled cusps of the pulmonic valve. (medscape.com)
  • The elongate body is movable from a first, flexible configuration for transluminal delivery to at least a portion of the coronary sinus to a second configuration for remodeling the mitral valve annulus. (justia.com)
  • Dilated cardiomyopathy occurs as a consequence of many different disease processes that impair myocardial function, such as coronary artery disease and hypertension. (justia.com)
  • Aortic valve replacement (AVR) may occasionally be required in infants and children. (medscape.com)
  • Several aortic valve repair techniques have been used in children, including pericardial leaflet extension, commissural reconstruction, annuloplasty, sinus of Valsalva reduction, sinotubular junction remodeling, and even complete leaflet replacement using autologous pericardium. (medscape.com)
  • The typical method of treatment is through surgery such as aortic valve reconstruction surgery (AVRS) and aortic valve replacement, usually with a synthetic valve. (wikipedia.org)
  • More than 49,000 mitral valve or aortic valve replacement procedures are performed annually in the U.S., along with a significant number of heart valve repair procedures. (justia.com)
  • There are two types of valve-sparing aortic root replacement (VSARR): the reimplantation technique, first described by David in 1992, and remodeling, introduced by Yacoub in 1983( 2 , 6 ). (kosuyoluheartjournal.com)
  • In this case, valve replacement may be performed. (hoag.org)
  • During aortic valve replacement surgery, the damaged valve is removed and replaced with an artificial valve called a prosthetic valve. (hoag.org)
  • Three of these options include: homograft aortic valves (from a human donor), mechanical aortic valve replacement, and stentless aortic valve replacement. (hoag.org)
  • The good news is Hoag was the first center in Orange County to offer a ground-breaking minimally-invasive procedure for individuals who need aortic valve replacement called Transcatheter Aortic Valve Replacement (TAVR) . (hoag.org)
  • However, when a valve is not projected to last that long, a replacement approach will be used. (hoag.org)
  • The prognosis is especially poor in the setting of acute heart failure, for which aortic valve replacement provides the least benefit. (medscape.com)
  • Aortic valve (AV) replacement is the gold standard in the treatment of AV disease. (scardio.ru)
  • Minimally invasive mitral valve replacement has become popular across the world. (biomedcentral.com)
  • In addition to valve repair, mitral replacement is an important alternative treatment. (biomedcentral.com)
  • However, annular rupture and patient - prosthetic mismatch (PPM) are still problematic and may affect short-term as well as long-term outcome after mitral valve replacement, particularly in the Asian population [ 2 ]. (biomedcentral.com)
  • Instead, surgeons tend to choose TAVR valve replacement surgery because it is minimally invasive, does not require extracorporeal circulation, and has a high rate of post-surgery recovery. (3dprint.com)
  • Factors that affected survival and need for subsequent aortic valve replacement were analyzed using univariate analysis. (elsevierpure.com)
  • 25 mm (p = 0.04), and male gender (p = 0.04) were predictors for subsequent aortic valve replacement. (elsevierpure.com)
  • Babliak O, Demianenko V, Babliak D, Marchenko A. Concomitant Minimally Invasive CABG with LV Restoration and Mitral Valve Replacement. (ctsnet.org)
  • The growing prevalence of heart-related disorders is notably driving the prosthetic heart valves market growth, although factors such as complications associated with prosthetic heart valve replacement may impede the market growth. (technavio.com)
  • Complications associated with prosthetic heart valve replacement is one of the factors limiting the prosthetic heart valves market growth. (technavio.com)
  • The rate of acute complications associated with heart valve replacement is high. (technavio.com)
  • The timing of valve replacement surgery might depend on how likely it is that your valve disease will get worse. (healthlinkbc.ca)
  • If your condition has been progressing slowly, you may be able to wait a little longer before having a valve replacement. (healthlinkbc.ca)
  • Valve replacement surgery has a high rate of success and a low risk of causing other problems if you are otherwise healthy. (healthlinkbc.ca)
  • A need for another replacement valve. (healthlinkbc.ca)
  • She recovered well without any complication after mitral valve replacement surgery. (sch.ac.kr)
  • This review focuses on the role of the Ross procedure in the treatment of aortic valve disease in children and young adults. (medscape.com)
  • The study aimed to evaluate the indications and describe the aortic valve reconstruction techniques by Ozaki's procedure in Vietnam and report mid-term outcomes of this technique in Vietnam. (authorea.com)
  • In line with the reimplantation procedure, the aortic root was dissected to the level below the aortic annulus. (kosuyoluheartjournal.com)
  • Nevertheless, many complications still plague this procedure, such as annulus rupture, acute coronary opening obstruction, and paravalvular leakage. (3dprint.com)
  • This procedure was done with peripheral cardiopulmonary bypass aortic cross-clamping and cold blood cardioplegia. (ctsnet.org)
  • Newer generationmechanical valves have shown less PPM than older generation, and stentless bioprosthesis have less PPM than stented prosthesis.Long-termclinical outcome of PPMis associatedwith adverse cardiovascular events especially in the presence of pre-existing left ventricle dysfunction or with concomitant procedure such as coronary artery bypass graft surgery. (ochsner.org)
  • Bicuspid and unicommissural unicuspid valves generally function normally for the first few decades, after which superimposed degenerative changes occur, at a faster rate that normal trileaflet aortic valves. (medscape.com)
  • Calcific aortic valve disease occurs on previously normally-functioning valves, either bi- or trileaflet, and less commonly on unicuspid valves. (medscape.com)
  • Moreover, mechanical valves require lifetime anticoagulation with associated activity limitations, difficulties with future pregnancy, and a lifetime risk of thromboembolic and bleeding complications due to potential poor compliance with anticoagulation protocol. (medscape.com)
  • The most common complications of QAV are aortic regurgitations. (wikipedia.org)
  • Based on his younger age (because risk of idiopathic fibrosis tends to increase in older people), lack of medication use and unremarkable medical history (e.g., no history of aortic valve surgery, Steinert disease or amyloidosis), we expanded our diagnostic workup. (cmaj.ca)
  • However, valve-sparing surgery has become popular in recent years( 2 , 3 ). (kosuyoluheartjournal.com)
  • [ 3 ] Degenerative aortic stenosis is currently the most common indication for valve surgery, as the population ages and newer techniques, such as minimally invasive surgery and transcutaneous methods, become available. (medscape.com)
  • Our experience with the MI trans-axillary direct approach in mitral valve surgery (MVS) ( 4 ) led us to consider that the aortic valve could be nicely exposed from the same approach. (annalscts.com)
  • Conclusion: Aortic valve-preserving surgery is possible with a low morbidity and mortality. (elsevierpure.com)
  • The rising incidence of CHD among infants increases the need for MI surgery and catheterization to correct the damaged heart valves. (technavio.com)
  • In such cases, it's important to discuss with your surgeon whether surgery should be offered - in some cases, it may be better to monitor the valve. (lhch.nhs.uk)
  • Patient has any concomitant valvular, aortic, coronary artery disease requiring surgery making AVR a Class I indication. (healthstudiesmn.org)
  • If you are going to have bypass surgery, your doctor may recommend that you have your valve replaced at the same time. (healthlinkbc.ca)
  • About 5% or less of people having valve surgery die. (healthlinkbc.ca)
  • This will depend on the type of valve you get and how long you live after you have the surgery. (healthlinkbc.ca)
  • Can I have surgery to repair my valve? (healthlinkbc.ca)
  • For most people, surgery to repair the aortic valve is not an option. (healthlinkbc.ca)
  • To learn more about tricuspid valve surgery, I encourage you to read "Evolving Trends in Tricuspid Valve Surgery" , an excellent research paper by Doctor McCarthy. (heart-valve-surgery.com)
  • I'm about half mitral valves and half aortic valves, but I also have a particular interest and experience in tricuspid valve surgery. (heart-valve-surgery.com)
  • Valve surgery, of all heart operations, it's still a bit of an art and not just a science. (heart-valve-surgery.com)
  • If you were going through mitral valve surgery and they tell you that the tricuspid valve is also leaking some, then you just want to know that the surgeon is aware of that. (heart-valve-surgery.com)
  • Mechanical valve prostheses are not ideal valve substitutes in children. (medscape.com)
  • I am just not having a great time with this artificial valve, although I've still been waffling on whether to go tissue or mechanical - if the tear is what's causing the issue then the valve is fine (as it has always appeared to be on the vast array of imaging across multiple media). (valvereplacement.org)
  • The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. (biomedcentral.com)
  • Pre-existing mechanical or bioprosthetic valve in any position. (healthstudiesmn.org)
  • If you have a mechanical valve, this risk is higher, so you will take an anticoagulant called warfarin (Coumadin). (healthlinkbc.ca)
  • Because of our patient's young age, the absence of other risk factors and his history of arthralgia, we requested a serum enzyme-linked immunosorbent assay (ELISA) analysis for Lyme disease on the day of admission. (cmaj.ca)
  • Each valve type has certain advantages and disadvantages, and the decision to use a certain type of valve is made after a discussion and careful evaluation of a patient's lifestyle, age, medical history and other factors. (hoag.org)
  • Repairing versus replacing the aortic valve is determined by a number of factors, such as the anatomy of the valve and the degree of its disease. (hoag.org)
  • Its 3D shape is designed to match the native anatomy of the aortic valve. (medgadget.com)
  • The HAART 300 Aortic Annuloplasty Device replicates the normal annular anatomy, having an elliptical base with a 2:3 minor-to-major axis ratio and three outwardly flaring posts spaced equally around the base circumference. (medgadget.com)
  • A good analogy for the function and anatomy of the mitral valve is a set of double doors. (lhch.nhs.uk)
  • Scar tissue alone can narrow the aortic valve and lead to aortic valve stenosis. (gh.ge)
  • Scar tissue can also create a rough surface on which calcium deposits can collect, contributing to aortic valve stenosis later in life. (gh.ge)
  • Tissue valve? (valvereplacement.org)
  • If I'm going with a tissue valve I'm thinking Ross because of the potential extra longevity, my relative youth, etc. (valvereplacement.org)
  • Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 × d (r = 0.744), 12.74 + 0.44 × d (r = 0.756) and 12.79 + 0.38 × d (r = 0.730), respectively. (biomedcentral.com)
  • Normally, the pulmonic valve is formed from three swellings of subendocardial tissue called the semilunar valves. (medscape.com)
  • In Noonan syndrome, tissue pad overgrowth within the sinuses interferes with the normal mobility and function of the valve. (medscape.com)
  • associated lesions included subAS (n=9), supravalvular AS (n=2), coarctation (n=5), and interrupted aortic arch (n=2). (elsevierpure.com)