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Related Concept Videos

Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Related Experiment Video

Updated: Nov 2, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Structural abnormalities after aortic root replacement with stentless xenograft.

Hanna Sofia Holmgren Dagnegård1, Per Ejlstrup Sigvardsen2, Nikolaj Ihlemann2

  • 1Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Cardiology, The Heart Center, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.

The Journal of Thoracic and Cardiovascular Surgery
|June 12, 2021
PubMed
Summary

Structural and functional abnormalities are common after Freestyle aortic root bioprosthesis implantation. Four-dimensional cardiac computed tomography (4DCT) is crucial for detecting these issues, which may increase reintervention risk.

Keywords:
aortic root replacementcoronary ostial stenosisleaflet abnormalitiespseudoaneurysmreimplanted coronariesstentless Freestyle bioprosthesis

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Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • The Freestyle stentless bioprosthesis is a key treatment for complex aortic root disease.
  • Assessing post-implantation abnormalities is vital for patient outcomes.

Purpose of the Study:

  • To determine the prevalence of structural and functional abnormalities after full-root Freestyle bioprosthesis implantation.
  • To evaluate the clinical impact of these abnormalities.

Main Methods:

  • A 2-center, cross-sectional study with clinical follow-up of 253 patients implanted between 1999-2017.
  • Utilized transthoracic echocardiography (TTE) and 4-dimensional cardiac computed tomography (4DCT) for assessment.
  • Median follow-up was 3.3 years pre-4DCT and 1.4 years post-4DCT.

Main Results:

  • Abnormalities were identified in 46% of patients, including pseudoaneurysms (13%) and coronary ostial stenosis (21%).
  • Transthoracic echocardiography (TTE) had limited sensitivity for detecting pseudoaneurysms.
  • 4DCT-identified abnormalities were linked to a 4.2-fold increased risk of reintervention (10% overall).

Conclusions:

  • Structural and functional abnormalities are frequent post-Freestyle implantation.
  • Transthoracic echocardiography (TTE) is insufficient for comprehensive follow-up.
  • Abnormalities may correlate with increased reintervention and adverse outcomes, warranting further investigation.