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Related Concept Videos

Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...

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Updated: May 23, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Complex aortic valve surgery for endocarditis using the beating-heart technique.

Marco Ricci1, Maria R Suarez, Anthony L Panos

  • 1From the Division of Cardiothoracic Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL USA.

Innovations (Philadelphia, Pa.)
|March 23, 2012
PubMed
Summary
This summary is machine-generated.

Beating-heart aortic valve surgery for endocarditis may preserve left ventricular (LV) function without improving survival compared to traditional methods. This technique offers an alternative myocardial protection strategy for complex cases.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Aortic valve surgery for endocarditis is associated with poor outcomes.
  • Postoperative left ventricular (LV) dysfunction can worsen outcomes.
  • Conventional myocardial protection strategies may be suboptimal in these complex cases.

Purpose of the Study:

  • To evaluate the initial clinical experience of a beating-heart technique for aortic valve surgery in patients with endocarditis.
  • To assess the impact of this technique on myocardial function preservation.
  • To report surgical outcomes and complications associated with this approach.

Main Methods:

  • A cohort of 30 consecutive patients with endocarditis underwent aortic valve repair or replacement using a beating-heart technique.
  • Prosthetic options included mechanical and biologic valves.
  • Patients presented with various comorbidities and complex valve pathologies, including severe insufficiency, vegetations, annular abscesses, and fistulas.

Main Results:

  • The study included 30 patients (22 men, 8 women; mean age 52.8 years) with diverse comorbidities and valve conditions.
  • Early mortality was 13.3% and late mortality was 10%, with higher mortality in salvage operations (42%).
  • No significant difference in LV function (ejection fraction, fractional shortening) was observed pre- and postoperatively, though LV end-diastolic dimension decreased.

Conclusions:

  • Beating-heart aortic valve surgery did not demonstrate improved survival compared to historical conventional methods.
  • This technique serves as a viable alternative for myocardial protection, potentially preserving LV function in complex aortic valve endocarditis surgeries.
  • Further research is needed to establish long-term survival benefits.