Aortic valve sparing surgery and influence on end-systolic diameter

master's thesis

• Title (croatian): Kirurgija očuvanja aortnog zaliska i utjecaj na promjer lijeve klijetke na kraju sistole
• Author: Ema Liu
• Mentor: Igor Rudež (mentor)
• Committee member: Igor Rudež (predsjednik povjerenstva)
• Committee member: Joško Bulum (član povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Aortic regurgitation, also known as aortic insufficiency is a condition due to incompetence of the aortic valve or any part of the aortic valve apparatus that causes diastolic flow of the blood into the left ventricle. When it becomes symptomatic, it presents similar to heart failure symptoms such as dyspnoea on exertion, orthopnoea, angina pectoris, palpitations and fatigue. Some of the causes of the aortic regurgitation are: rheumatic fever, endocarditis, bicuspid aortic valve which is an anatomical variation that occurs in 2% of the population and unicuspid or quadricuspid that occurs in less than 1%, respectively. Patients diagnosed with aortic regurgitation have high mortality rate if left untreated. Surgical treatment such as aortic valve replacement and aortic valve repair, can significantly increase survival rate in those patients. Aortic valve repair is commonly used on BAV and has a good success rate. There are various types of procedures that might be performed like commissurotomy, valvuloplasty, reshaping, decalcification, repair of structural support or patching. Although aortic valve repair is a more complex technique compared to aortic valve replacement but it is used commonly since it avoids unnecessary risks of thromboembolism, endocarditis and bleeding due to long-term anticoagulation therapy needed after replacement of the valve with a mechanical or biologic prosthesis. Echocardiography is used for preoperative and postoperative follow up of the patients to assess ventricular function by measuring the left ventricular ejection fraction, left ventricular end-diastolic diameter and left ventricular-systolic diameter.

Abstract (croatian)

Aortna regurgitacija, također poznata kao aortna insuficijencija je stanje nastalo zbog nesposobnosti aortnog zaliska ili bilo kojeg dijela aparature aortnog zaliska koji uzrokuje dijastolički protok krvi u lijevu klijetku. Kada postane simptomatična, prikazuje se sličnim simptomima srčanog zatajenja kao što su dispneja pri naporu, ortopneja, angina pectoris, palpitacije i umor. Neki od uzroka aortne regurgitacije su: reumatska groznica, endocarditis, bikuspidalan aortni zalisak kao anatomska varijacija koja se pojavljuje u 2% populacije i unikuspidalan i kvadrikuspidalni zalisci koji se pojavljuju u manje od 1% populacije. Pacijenti s dijagnozom aortne regurgitacije imaju visoku stopu smrtnosti ako se ne liječe. Kirurško liječenje poput zamjene aortnog zaliska ili očuvanja aortnog zaliska mogu značajno povećati stopu preživljavanja kod tih pacijenata. Kirurgija očuvanja aortnog zaliska se obično koristi kod pacijenata s bikuspidalnim aortnim zaliskom i ima visoku stopu uspješnosti. Postoje razne vrste postupaka koji se mogu izvoditi poput komisurotomije, valvuloplastije, preoblikovanje, dekalcifikacije, popravak potpornih struktura ili krpanje. Iako je popravak aortnog zaliska složenija tehnika u usporedbi sa zamjenom aortnog zaliska, koristi se često jer se time izbjegavaju nepotrebni rizici tromboembolije, endokarditisa i krvarenja zbog dugotrajne antikoagulacijske terapije potrebne nakon zamjene zaliska sa mehaničkom ili biološkom protezom. Ultrazvuk se koristi kao preoperativno i postoperativno praćenje bolesnika za procjenu ventrikularne funkcije mjerenjem frakcije izbacivanja lijeve klijetke te promjera lijeve klijetke na kraju dijastole i sistole.

• Keywords: aortic valve repair; aortic regurgitation; ventricular function
• Keywords (croatian): kirurgija očuvanja aortnog zaliska; aortna regurgitacija; ventrikularna funkcija
• Language: english
• URN:NBN: urn:nbn:hr:105:650976
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-07-15 11:20:58