Herz
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Calcified aortic stenosis is the predominant valve disease. Patients affected are most commonly elderly people, who often show associated comorbidities like reduced left ventricular function, impaired renal function, and pulmonary hypertension. The risk of open-heart surgery is elevated. ⋯ The technical improvement of balloon valvuloplasty is the percutaneous heart valve, which is under present clinical investigation. The antegrade/transseptal and retrograde approaches are used, as is the transapical access to the left ventricle. Even if long-term results are not yet available and the procedures still require technical improvement, especially minimization of catheter size, percutaneous valve replacement is a new chapter in the treatment of the calcified aortic stenosis.
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Comparative Study
[Indication, technique, and results of aortic valve and ascending aorta reconstruction].
Aortic valve replacement is the standard procedure in patients with aortic valve regurgitation (AR). Although long-term results for both biological and mechanical heart valves could be improved, a valve-sparing operation has several advantages especially in young patients. Alterations in the geometry of the aortic root, especially dilatation of the sinutubular junction, are the primary cause of AR in patients with aneurysms of the ascending aorta. ⋯ With low surgical mortality and morbidity, excellent clinical and functional long-term results can be achieved. Furthermore, the lack of the necessity of anticoagulation as well as positive hemodynamic factors argue for a valve-sparing surgical technique. A final evaluation of the method is not possible, however, until long-term follow-up of up to 20 years is available and the positive results have been confirmed.