Duke Cameron, MD Division of Cardiac SurgeryCerebrovascular Arteries Individualized approach...

Duke Cameron, MDDivision of Cardiac SurgeryDivision of Cardiac Surgery

No financial disclosures

No disclosures

No financial disclosures

Acknowledgement of Drs.Vricella, Black and Dietz

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Loeys-Dietz Syndrome

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LDS Aortopathy

• Root Aneurysm• Root Aneurysm

• Arterial Tortuosity

• Dissection/Rupture at• Dissection/Rupture atyoung age and smallaortic sizeaortic size

• Peripheral aneurysms• Peripheral aneurysms

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Aortic Root Replacement in LDS

5 79 LDS operations

Operative Experience with LDS

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ARR in LDS: Operative Technique

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Bentall Reimplantation VSRR

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Concomitant Procedures

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Operative Results

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Late Results

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No reoperations for AR in trileaflet David VSRRs

Special Considerations

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Coronary artery button aneurysms

“Hershey Kiss” aneurysms

Arch Reinterventions in LDS

Mos

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LVOT Pseudoaneurysm

• Typically arising from subanular• Typically arising from subanularsutures in NC sinus, thru aorto-mitral apron

• Can be PSA or fistula to LA or• Can be PSA or fistula to LA orRA

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Conclusions: ARR in LDS

• Low operative risk (0% mortality)

• Valve sparing operations have good• Valve sparing operations have goodearly and midterm results

• High re-intervention rate• High re-intervention rate

• Close surveillance necessary postop• Close surveillance necessary postop

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Recommendations

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