Aortic Root Surgery The Biological Solution
The surgical treatment of the aortic valve and root disease, organic and ischemic mitral regurgitation, and endocarditis has made great strides. Still, there is the well-known dilemma: on the one hand the need for anticoagulation in patients with mechanic
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Aortic Root Surgery
C. A. Yankah Y. Weng R. Hetzer (Eds.)
Aortic Root Surgery The Biological Solution With 271 Figures in 434 Separate Illustrations, Most in Color, and 108 Tables
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Charles A. Yankah, MD, PhD Professor of Surgery Yuguo Weng, MD Professor of Surgery Roland Hetzer, MD, PhD Chairman, Professor of Surgery Deutsches Herzzentrum Berlin & Charité Medical University Berlin Augustenburger Platz 1 13353 Berlin, Germany
ISBN 978-3-7985-1868-1 Springer-Verlag Berlin Heidelberg New York Bibliographic information published by Die Deutsche Nationalbibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at http://dnb.d-nb.de. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Steinkopff Verlag. Violations are liable for prosecution under the German Copyright Law. Springer Medizin Springer-Verlag GmbH, a member of Springer Science+Business Media springer.de © Springer-Verlag Berlin Heidelberg 2010 Printed in Germany The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about the application of operative techniques and medications contained in this book. In every individual case the user must check such information by consulting the relevant literature. Medical Editor: Dr. Annette Gasser Production: Klemens Schwind Cover Design: WMX Design GmbH, Heidelberg Typesetting: K+V Fotosatz GmbH, Beerfelden SPIN 12589456
85/7231-5 4 3 2 1 0 – Printed on acid-free paper
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To our families and loved ones, whose unrelenting understanding of the demands of our surgical and scientific lives made this book possible
Preface
The surgical results of bioprosthetic aortic valve replacement in the 1960s and 1970s were not very satisfactory. The search for the ideal substitute for the diseased aortic valve led Donald Ross to develop the concept of the aortic allograft in 1962 and the pulmonary autograft in 1967 for subcoronary implantation, and later, in 1972, as a full root for replacing the aortic root in the infected aortic valve with a root abscess. The aortic allograft and pulmonary autograft surgical procedures were revolutionary in the history of cardiac valve surgery in the last millennium because they compete well with the bioprosthesis, are nonthrombogenic (thus, requiring no postop
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