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Aortic Pathology and Therapeutic Strategies
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Aortic Pathology and Therapeutic Strategies

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 3076

Special Issue Editors

Dr. Filip Dulguerov

E-Mail Website
Guest Editor
Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1010 Lausanne, Switzerland
Interests: mitral valve repair; aortic valve repair; mechanical support in cardiac failure; aortic valve sparing operations
Prof. Dr. Matthias Kirsch

E-Mail Website
Guest Editor
Service of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
Interests: mitral valve repair; aortic valve repair; mechanical support in cardiac failure; aortic valve sparing operations

Special Issue Information

Dear Colleagues,

The purpose of this special issue is to provide an update on the pathology of the aortic valve and the aortic root through publications from opinion leaders and experienced surgeons surgeons from around the world. We will cover the following topics: aortic valve repair, valve sparing aortic root replacement, the Ross procedure (modified or not) in adulthood, stentless bioprostheses for aortic valve and aortic root replacement, sutureless bioprosthesis, the positionning of the Ozaki procedure and finally the debate of TAVI (including the transcervical variant) versus traditional aortic valve replacement.

This is a very interesting subject at present, essentially regarding the positioning of the different therapeutic strategies for a given patient. It will be very interesting to develop for for both cardiologists and surgeons, thereby reaching a wide audience.

Dr. Filip Dulguerov
Prof. Dr. Matthias Kirsch
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic valve repair
  • aortic valve sparing operations
  • TAVI vs SAVR
  • trans carotid approach for complex TAVI
  • Ross procedure
  • Ozaki procedure
  • decellularized pericardium as valvular substitute
  • mechanical aortic prosthesis without necessity of anticoagulants
  • sutureless aortic valve replacement

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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11 pages, 1740 KiB  
Article
Aortitis Increases the Risk of Surgical Complications and Re-Operations After Major Aortic Surgery
by Edward Staniforth, Shirish Dubey, Iakovos Ttofi, Vanitha Perinparajah, Jasmina Ttofi, Rohit Vijjhalwar, Raman Uberoi, Ediri Sideso and George Krasopoulos
J. Cardiovasc. Dev. Dis. 2024, 11(12), 405; https://doi.org/10.3390/jcdd11120405 - 17 Dec 2024
Viewed by 999
Abstract
Aortitis, defined as inflammation of the aorta, can lead to aneurysms and dissections. Intra-operative sampling is essential for diagnosis, with many cases presenting asymptomatically as clinically isolated aortitis. Previous studies investigating aortitis in major aortic surgery have been limited by low intra-operative sampling. [...] Read more.
Aortitis, defined as inflammation of the aorta, can lead to aneurysms and dissections. Intra-operative sampling is essential for diagnosis, with many cases presenting asymptomatically as clinically isolated aortitis. Previous studies investigating aortitis in major aortic surgery have been limited by low intra-operative sampling. We performed an 11-year, retrospective, cross-sectional study to investigate the true prevalence of aortitis in thoracic aortic aneurysms and dissections by analysing all major aortic operations performed in a single centre. We collected medical histories, histological reports, post-operative outcomes and follow-up data; 537 patients met the inclusion criteria, representing an 88% histological sampling rate. The prevalence of aortitis was 10.6% (n = 57), of which 75% were clinically isolated. The re-operation rate in aortitis was twice that of non-aortitis patients (17.5% vs. 9.4%, p = 0.054). Multivariate logistic regression identified increased age, female sex, current smoking, and other inflammatory diseases as significantly associated with aortitis, with a bicuspid aortic valve associated with a significantly decreased likelihood of aortitis. The true prevalence of aortitis is likely higher than reported in previous studies, with our study showing twice the prevalence found in previous studies with lower sampling rates. Due to the increased re-intervention in aortitis, specialist multi-disciplinary follow-up and aortitis centres should be formed. Full article
(This article belongs to the Special Issue Aortic Pathology and Therapeutic Strategies)
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9 pages, 461 KiB  
Article
Progression, Management, and Outcome of Aortic Valve Stenosis in Systemic Sclerosis: A Case Series
by Andrea Vergara, Antonio Orlando, Eleonora Caiazza, Serena Vettori, Giovanna Cuomo, Paola Argiento, Emanuele Romeo, Rosa Franzese, Berardo Sarubbi and Michele D’Alto
J. Cardiovasc. Dev. Dis. 2024, 11(9), 274; https://doi.org/10.3390/jcdd11090274 - 4 Sep 2024
Viewed by 1140
Abstract
Background: In systemic sclerosis (SSc), cardiac involvement is frequent, heterogeneous, and related to a poor prognosis. Due to a longer life expectancy, the development of degenerative aortic stenosis (AS) is not uncommon. The aim of this article is to report the characteristics of [...] Read more.
Background: In systemic sclerosis (SSc), cardiac involvement is frequent, heterogeneous, and related to a poor prognosis. Due to a longer life expectancy, the development of degenerative aortic stenosis (AS) is not uncommon. The aim of this article is to report the characteristics of AS in SSc, analyzing the rate of progression, the management, and the outcome. Methods: This is a case series conducted at the Department of Cardiology of Monaldi Hospital, Naples, Italy. Results: From January 2007 to December 2022, we analyzed 234 patients with SSc. Ten/234 patients (4.3%) showed severe AS and were included in the analysis (age 75.5 years [IQR 58–84], nine females). Nine had limited and one diffuse SSc. Two patients were in NHYA/WHO II and eight in NYHA/WHO III. All had degenerative three-leaflet AS. Two patients showed severe AS at the first evaluation, and eight developed severe AS during the follow-up, with a time progression from moderate to severe AS of 3.2 ± 1.1 years (progression rate −0.190 ± 0.012 cm2/year for aortic valve area, 8.6 ± 6.1 mmHg/year for mean aortic gradient, 16 ± 7 mmHg/year for peak aortic gradient, and 0.5 ± 0.3 m/s/year for aortic peak velocity). Seven out of 10 patients underwent transcatheter aortic valve implantation (TAVI), one underwent surgical aortic valve replacement (SAVR), one was left untreated, and one was on a waiting list for TAVI. No major complications after TAVI or SAVR occurred. At a mean follow-up of 5.9 ± 3.9 years, eight patients are alive and two died. Conclusion: Severe AS is a relevant cardiac complication of SSc and must be considered in the screening and during the follow-up. Its rapid progression rate may tentatively be due to autoimmunity, degenerative burden, and chronic inflammation. Full article
(This article belongs to the Special Issue Aortic Pathology and Therapeutic Strategies)
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Review

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14 pages, 5777 KiB  
Review
Optimal Management of Spontaneous Aortic Thrombus Floating in the Ascending Aorta, from a Single Case Experience to a Literature Review
by Jacopo Gardellini, Daniele Linardi, Venanzio Di Nicola, Gino Puntel, Giovanni Puppini, Luca Barozzi and Giovanni Battista Luciani
J. Cardiovasc. Dev. Dis. 2025, 12(4), 146; https://doi.org/10.3390/jcdd12040146 - 9 Apr 2025
Viewed by 347
Abstract
As spontaneous ascending aortic thrombi (AATs) are uncommon in modern clinical practice, despite the application of new technology and the widespread use of contrast-enhanced computer tomography during primary assessments in patients without underlying predisposing conditions, a thrombus floating in the ascending aorta is [...] Read more.
As spontaneous ascending aortic thrombi (AATs) are uncommon in modern clinical practice, despite the application of new technology and the widespread use of contrast-enhanced computer tomography during primary assessments in patients without underlying predisposing conditions, a thrombus floating in the ascending aorta is rarely discovered in a timely manner; moreover, the ascending tract represents an unusual site for thrombus formation. The clinical presentation of AATs is also often in the form of peripheral arterial embolization, which can cause a wide variety of symptoms, from stroke to limb ischemia, and thus delay correct diagnosis. Medical management is a risky strategy, while surgical treatment is usually challenging due to the risk of thrombus dislodgement and difficulties related to prior embolization complication management. In this study, faced with a peculiar case of embolic stroke in an otherwise healthy 71-year-old woman, we analyzed the status of knowledge on spontaneous ascending aortic thrombus treatments and outcomes. A multidisciplinary approach represents the best choice for defining a patient’s timing of surgery and ensuring the management of complications. Sequential multistage treatment minimizes further complications and prevents worsening patient outcomes, leading to the best management for every possible clinical presentation. A less invasive surgical approach could lead to complete resolution of the pathology, avoiding further potentially lethal complications, facilitating postoperative management, avoiding delayed treatments, and resulting in better outcomes. Full article
(This article belongs to the Special Issue Aortic Pathology and Therapeutic Strategies)
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