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Epair by simple root reduction using a periaortic dacron sleeve graft for the treatment of functional type i ai due to aortic root aneurysm. viagra generic wikipedia The sleeved aortic root is dimensionally stable after 32 ± 6. can i cut viagra pills in half 3 months, and the valvuloplasty is acceptably competent, as evidenced by preserved lv geometry. Mean follow-up of 32 months is at best midterm and short of the reported 7- to 10-year durability of current valve reimplantation procedures, but the sleeve repair offers a considerably less complicated alternative and merits further evaluation.
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Historically, the bioprosthetic valve conduit has been a widely used solution for avoiding anticoagulation while effecting a reliable reconstruction of the root and ascending aorta. does 5 mg of viagra work The predictable durability of modern bioprosthetic valves compared with repaired aortic valves is attractive, but the inevitable valve redo operation may be formidable.
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For this reason, the tissue valve conduit reconstruction has been largely replaced by aortic root remodeling or valve reimplantation procedures [3, 4].
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Growing evidence of sinus expansion after root remodeling procedures has made valve reimplantation the more appealing repair, particularly after de oliveira and colleagues  observed in marfan patients that 96% remained free of ai exceeding 2+ a mean of 8 years after a reimplantation valve-sparing procedure, but only 71% were free of ai exceeding 2+ after root remodeling.
Expansion of the residual sinus wall may be unique to the marfan population, but the sinuses rather than the leaflets appear to be the more unpredictable component in root remodeling procedures. Like other reimplantation techniques, with the sleeve repair the entire root resides within an unyielding conduit, avoiding unpredictable sinus expansion or speculation about the expression of a patient's genotype for connective tissue disorders. viagra canada price Dimensional stability of the sleeved root is confirmed by the unchanged stj diameter from 1 week to 3 years (p = 0. viagra 5 mg daily side effects 70). Further, the sleeve accomplishes a stable repair of the aortic root and also avoids the need for radical sinus resection and coronary artery transfer.
Aortic valve reoperations after some root reconstruction techniques may be complicated by numerous suture lines from the dacron graft to the aorta, but although no florida sleeve patients have undergone reoperation yet, the dissection inside the root should not be hampe.
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