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. 2020 Sep 25;13(3):248-254.
doi: 10.3400/avd.oa.20-00113.

Neomedia Repair of the Valsalva Sinus in the Treatment of Acute Type-A Aortic Dissection: Long-term Effectiveness and a Case of Pathology

Nobuhisa Ohno  1 , Toshi Maeda  1 , Otohime Kato  1 , Hirofumi Sato  1 , Go Ueno  1 , Kosuke Yoshizawa  1
Affiliations

Neomedia Repair of the Valsalva Sinus in the Treatment of Acute Type-A Aortic Dissection: Long-term Effectiveness and a Case of Pathology

Nobuhisa Ohno et al. Ann Vasc Dis. .

Abstract

Although numerous surgical techniques are employed to treat acute Stanford type A aortic dissection (ATAAD), controversy remains over which is the best procedure for aortic root reconstruction. Among the various techniques utilized, neomedia repair is considered to be more promising than adhesive-only repair for the treatment of a dissected aortic root. We experienced a series of neomedia sinus Valsalva repair using woven polyester fabric, and evaluated the aortic root diameter by computed tomography and severity of aortic valve insufficiency by transthoracic echocardiography. The aortic root diameter was well preserved with no progress of aortic valve insufficiency in the long-term period. Furthermore, we found that the fabric looked functioning new media in the findings obtained from the pathological examination of a neomedia repaired aortic wall sample that was obtained by chance from a patient during valve replacement surgery performed 10 years after aortic reconstruction for ATAAD. Neomedia repair using woven polyester fabric for ATAAD might facilitate the long-term durability of the surgically treated aortic root. (This is a translation of J Jpn Coll Angiol 2019; 59: 37-43.).

Keywords: aortic dissection; aortic root; neomedia; pathology; polyester fabric.

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Conflict of interest statement

Disclosure StatementAll authors have no conflicts of interest to declare.

Figures

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Fig. 1 Schema of the neomedia repair technique.
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Fig. 2 Photograph of prepared neomedias and an operative procedure.
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Fig. 3 Postoperative survival including hospital death.
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Fig. 4 Freedom from aortic reoperation.
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Fig. 5 Postoperative follow-up of aortic regurgitation.
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Fig. 6 Intraoperative views of the first operation and the second aortic valve replacement for a patient of degenerated bicuspid aortic valve.
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Fig. 7 Pathological view of the neomedia repaired aortic wall derived from a patient who had the aortic valve replacement for the degenerated bicuspid aortic valve.
See this image and copyright information in PMC

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