Extraanatomical Bypass of the Aortic Root: An Experimental Technique

John W. Brown, Claudio A. Salles, Marvin M. Kirsh

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Endocarditis involving a prosthetic aortic valve is associated with persistently positive blood cultures and aortic regurgitation. With rare exception, it is a fatal disease. An experimental technique was developed that would allow for removal of the infected aortic prosthesis with debridement and permanent closure of the aortic root. An extraanatomical outflow for the left ventricle was created using a valve-containing conduit between the apex of the left ventricle and the descending thoracic aorta (apicoaortic anastomosis). The procedure was performed on 5 mongrel dogs through a left thoracotomy without use of cardiopulmonary bypass. Four survived the procedure and required no cardiotonic support. One died as a result of a technical problem. Intraoperative pressure determination revealed a 0 to 15 mm Hg gradient across the apicoaortic prosthesis and a left ventricular enddiastolic pressure of 0 to 4 mm Hg. Both postoperative angiocardiogram and postmortem examination confirmed patency of the aortocoronary bypass grafts and good function of the prosthesis.

Original languageEnglish (US)
Pages (from-to)433-438
Number of pages6
JournalAnnals of Thoracic Surgery
Volume24
Issue number5
DOIs
StatePublished - Jan 1 1977
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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