Baraki 4070 r1.qxd:Layout 1
نویسندگان
چکیده
Currently, composite replacement with a mechanical-valved conduit, as first described by Bentall and De Bono, represents the standard treatment for the repair of aortic aneurysms with aortic valve pathology (1-3). However, the need for anticoagulation resulting in thromboembolic complications, the increasing age of patients, and the poor long-term durability of biological prostheses has led to a shift towards the use of tissue-valved conduits (4-9). In the past, the manufacture of tissue-valved conduits has proved to be difficult because of the different storage modalities of the components. Tissue valves are stored in fluid to which glutaraldehyde has been added, whereas a coated Dacron tube must be stored dry in order to maintain its impermeability to blood. Consequently, until recently it was necessary for the surgeon to assemble the tissue-valved conduit on the surgical table following sizing of the aortic annulus, and this led (at least potentially) to an extension of the aortic cross-clamp time and a prolongation of cardiac ischemia. For this reason, very few surgeons assemble a ‘home-made’ stentless tissue-valved conduit intraoperatively. Moreover, these ‘home-made’ conduits have not been tested in vitro, thus increasing the risk of unrecognized prosthetic dysfunction (10).
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1Department of Pediatrics (Cardiology), University of California, San Francisco, USA, 2Gladstone Institute of Cardiovascular Disease, University of California, San Francisco, USA, 3Department of Cardiac Surgery, University Clinic of SchleswigHolstein, Campus Lübeck, Lübeck, Germany, 4Cardiology Section and Research Service, San Francisco VA Medical Center, San Francisco, USA, 5Department of Med...
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