Replay of: Maximizing Left Ventricular Mass Regression: Surgical Options in Aortic Valve Replacement

First Seen Live Webcast: Tuesday, December 7, 2004 1:30 PT, 4:30 ET (21:30 UTC)- Real Player Required

Sequoia Hospital

Redwood City, CA- Oddly enough, the purpose of aortic valve replacement is not solely to install a new aortic valve but to achieve left ventricular mass reduction. This means that a successful aortic valve replacement not only sutures in a new prosthesis, but sutures in a prosthesis large enough to allow the left ventricle to return to normal thickness. About 75% of the time this will be done easily because the site where the aortic valve prosthesis is implanted is big enough to accommodate a valve that will permit the left ventricle to return to normal. In about 25% of cases, however, the aortic annulus is not large enough to accept a prosthesis big enough to permit such a result. In that case, there are a number of technical possibilities that permit surgeons to implant a valve that will be maximally beneficial to the patient. Today you will see one of these procedures called left ventricular outflow tract enlargement. This is certainly not a new procedure. It's been done for many years, but it has not been widely done, and some researchers have thought that it is associated with a higher mortality risk. Drs. Gaudiani and Castro perform this operation routinely and they have published a paper on this which demonstrates that the technique certainly allows a larger valve to be placed and that the risk is no higher than that found in aortic valve replacement by the usual means. This webcast presented all the details that permit a surgeon to successfully complete this operation.

	Aortic Valve Replacement

In addition, Drs. Gaudiani and Castro have performed about 500 aortic valve replacements and another 300 mitral valve replacements through limited incisions in the chest. This includes such a procedure as will be shown today. It is very likely that they will be using a mini sternotomy as the incision through which to replace the aortic valve and enlarge the left ventricular outflow tract.

Aortic Valve Replacement

Drs. Vincent Gaudiani and Luis Castro at Sequoia Hospital presented the small incision Aortic Valve Replacement in a live webcast on December 7 at 4:30 pm EST. Watch the archive today.

This continuing medical education activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians Practice and slp3D.

Physicians Practice is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians Practice designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician's Recognition Award. This activity is supported by an unrestricted educational grant from Medtronic.