By John B. McCraw
Every one full-color quantity during this three-book sequence exhibits the reconstructive recommendations for a selected anatomical sector. As within the unique McCraw and Arnold's Atlas of Muscle and Musculocutaneous Flaps (1986), each one flap is verified in cadaver dissection and scientific case photos, and the textual content is in an easy-to-read define structure to function a prepared reference for the anatomical foundation and medical software of every flap. Highlights of this sequence are the full-color photos and the broad bibliographies.
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If the SOV diameter is less than 29 mm, then a 26 mm valve should be selected. If the distance of the coronary ostia to the annulus or the diameter at the STJ is also on the small side, the smaller valve should be used. The calcification of the annulus is also important to consider in these intermediate circumstances. A heavy calcified, symmetric annulus is more likely to accept and seal the smaller valve. If there is very little or asymmetric calcification, a larger valve will likely seal better.
This is a straight guidewire with a 1 cm flexible tip previously shaped to a pigtail configuration (Boston Scientific, Natick, MA). Aortic Valvuloplasty Aortic valvuloplasty is not routinely performed except in patients with heavily calcified aortic valve or bicuspid valves. Although implantation success rate with and without valvuloplasty is the same, preimplantation valvuloplasty is associated with a higher rate of stroke and permanent pacemaker [7]. Preimplantation valvuloplasty is performed with a 5 or 6 cm long NuMED Z-MED II balloon (B.
Reconstructions of the aortic root are performed and dimensions are obtained from the left ventricular outflow tract, the aortic annulus (Annulus) (major, minor, and mean diameter and perimeter), each sinus of Valsalva diameter (SoV), sino-tubular junction (STJ) diameter (minor, major, and mean), and ascending aorta diameter (minor, major, and mean) at 4 cm from the annular plane (AscAo). The distances from the annular plane to each coronary artery ostium (coronary artery height, A) and to the sino-tubular junction for each sinus (sinus of Valsalva height, B) are also measured.