Bo Yang
@BoYangMD
Followers
3,639
Following
993
Media
29
Statuses
587
Cardiac Surgeon I University of Michigan, Michigan Medicine
Ann Arbor, MI
Joined September 2018
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Telegram
• 1415060 Tweets
Hezbollah
• 192427 Tweets
SB19 RED CARPET PREMIERE
• 86276 Tweets
ダンス・ダンス・ダンス
• 76779 Tweets
1Z BALIBAGAN SA RED CARPET
• 36377 Tweets
ST☆RISH
• 34744 Tweets
BINI PLEASE PERFORM PANTROPIKO
• 32457 Tweets
Christoph Daum
• 32432 Tweets
#Cvitt1000mgXZeeNunew
• 30694 Tweets
サトノレーヴ
• 16087 Tweets
BEOMGYU FIRST PITCH
• 16071 Tweets
#BACKSLIVEで愛し合おう
• 15691 Tweets
#じゅじゅフェス
• 14940 Tweets
モレイラ
• 14744 Tweets
#PAKvsBAN
• 13092 Tweets
#reflame_961_SUN
• 12259 Tweets
ナムラクレア
• 11360 Tweets
We developed a new technique, a "Y" incision and rectangular patch to enlarge the aortic annulus by 2-3 valve size without cutting into the MV, RVOT, or LA. it is very effective and safe. Paper published in JTCVS Tech.
CentralFigure.tif
29
39
297
Explanted 23 sapient, enlarged the annulus from 19 to 25. The opening of old TAVR valve was < 1/3 of the new SAVR valve. coronary Ostia were above the SAVR valve. Aortic annular enlargement should be routine in SAVR like LIMA in CABG, especially in redo SAVR after SAVR or TAVR.
15
37
239
Sarah did the whole case! Well done Sarah!!!!!
Another type A dissection in the books with
@BoYangMD
“Michigan Style” -
no felt, no bioglue, no pledgets (and no transfusions 🩸) Great mentor with superb technique
@UMichCTSurgery
@UMichSurgery
@GAilawadiMD
17
25
375
4
9
147
Last case with our aortic fellow, Ken Hassler. Congratulations, Ken, a bright future is waiting for you!!
4
5
132
In MV or AV repair, we don’t accept mild MR or AI. But why do we tolerated mild even mod AS after AVR for AS Pts. As a specialty, We should consider root enlargement as a standard care for AS Pts with normal annulus due to the sewing ring and struts of prosthetic valve!
11
15
106
Share our experience of Mosaic valve too. 4-year old, 21 mm Mosaic, pristine, but too small, mean gradient was 46 mmHg, inner diameter was 14 mm. "Y" incision/rectangular patch, replaced with a 27 Magna, mean G: 3 mmHg, peak G: 6. Any stented valve <25 should not be implanted.
13
17
104
Great to have Sarah Chen, CT resident fro UC Davis visiting us for a week as the winner of TSRA/STS Traveling Fellowship in Cardiothoracic Surgery
1
9
103
Dept of Cardiac Surgery at Umich hosted the first wet lab of aortic root enlargement for cardiac surgeons in Michigan through MSTCVS. great time with Colleagues
@GAilawadiMD
@KarenMKimMD1
@ShinFukuharaMD
photo from Jerry_all.heicKaren Kim.heicAilawadi.heicBo.heic
6
5
89
Very kind of the reviewers of CTSNet. We hope every surgeon can use technique to give Pts much bigger valve they deserve!!!!
And finally, our number 1 most popular video of 2021!
A “Y” Incision/Rectangular Patch to Enlarge the Aortic Annulus by 4 Valve Sizes in TAV and BAV Patients
By Bo Yang
0
9
34
3
10
79
We have done 140+ consecutive now, including two cases of endocarditis. The results remained the same. Hemodynamics and LVH further improved in the second year. Median AVA went up to 2.4 cm2, and mean gradient remained 6-7 mmHg, better than TAVR (presented at STS 2023)
.
@BoYangMD
@umichmedicine
et al. took a look at the safety and efficacy of
#aortic
valve replacement with Y-incision aortic annular enlargement and gave conclusions based on the findings in
#JTCVS
. Read more:
0
13
35
2
11
77
This is the updated steps and results of Y incision aortic annular enlargement of 119 pts. Anyone can download this article using this link if they are interested.
2
11
79
This is the updated steps and results of Y incision aortic annular enlargement of 119 pts. Anyone can download this article using this correct link if they are interested.
1
19
77
Congratulations to our graduating aortic fellows, Alex Brescia, Ken Hassler and Farhang Yazdchi. You all have done a great job. The world is waiting for you!! Good luck to your new jobs. You all have bright future!! Save more patients!!
2
6
68
We modified the aortotomy closure to enlarge the proximal aorta in a complete or partial aortotomy. Better flow and set up for VinV TAVR. Papers are in press in JTCVS Tech and Ann Thor Surg.
7
8
66
this is the link to the issue in May in ACS, papers, presentations, videos by experts in TAVR-SAVR trials, PPM, valve size, root anatomy, SVD, techniques of annular enlargement, pitfalls and updates, illustrations of Y-incision. It’s open to everyone
1
16
54
The aortic club of Michigan graduated, current, and coming aortic fellows at STS 2024. Great meeting, great reunion
1
9
52
PARTNER 3 by no means was designed to study the effect of root enlargement. Comparing small annuli needing ARE to large annuli who didn’t need ARE. wrong message. The design should be randomizing the patients with small annulus and same annular size into AVR and AVR + AAE
#STS2024
@VinodThourani
presenting
#PARTNER3
SAVR outcomes: isolated SAVR show outcomes similar to benchmark
#STS
-database outcomes, better than SAVR-concomitant
Root enlargement just 5%, yet higher mortality than isolated SAVR
1
14
41
4
4
44
@PPibarot
@practicalcardio
SAVR valves are too small. More PPM. TAVR valves have no sewing ring, better gradient. Not surprising SAVR Valves had more SVD. PPM increase SVD. We need put larger SAVR valve in Pts with root enlargement. The most common SAVR size wa 21-23. Should be size 27-29.
12
5
44
Great job from our aortic fellow, Dr. Sarah Palmer
🔥Nice
@ctsnetorg
video by
@BoYangMD
and
@sarah_wardCT
showing how to use a “Y” incision and rectangular patch to enlarge the aortic annulus by 3/4 valve sizes for SAVR mechanical prosthesis. The aortic annulus was enlarged 4 sizes (from 19mm to 27mm).👍
3
20
90
4
2
39
Different cannulation strategies are different tools for us. Choose the right tool for the individual pt.
#OpenAccess
#GraphicalAbstract
Aortic and arch branch vessel cannulation in acute type A aortic dissection repair. Read the full article in JTCVS Techniques by Norton, Yang, et al:
#JTCVS
#CardioTwitter
#cvsurg
@AATSHQ
@tssmn
@BoYangMD
@elnortonMD
1
3
25
0
5
37
Look into figure 8. The PPM defined using EOA by individual echo measurement reflects dramatic difference of long term survival between no PPM and any PPM. That’s how PPM should be defined, not the EOA from valve company or predicted EOA published in literature
🔥Hot off the press🔥 Read our study published in
@JAHA_AHA
about
#PPM
after
#SAVR
#StructuralHeart
🫀
💥⬆️risk of ☠️, ❤️☠️,
#HF
🏥
💥💃 with ⬆️ risk of ☠️
@XanderJacquemyn
@JefVandenEynde
#DannyChu
@DSGMD
@tjarkebels
@ClavelLabo
@PPibarot
@IbrahimSultanMD
5
14
64
0
7
35
Our med student Armi presented at AATS last year and again at STS this year in San Diego. So proud of him! Way to go, Armi!!
1
3
35
That’s what I teach every resident and fellow
10 essential structures of the aortic root!
@BoYangMD
1: anatomical annulus
2: R coronary os
3: L coronary os
4: 3 cusps
5: 3 sinuses
6: 3 interleaflet triangles
7: basal ring
8: VAJ
9: widest extent of sinuses-determine the size of graft for the David
10: STJ
1
17
68
0
2
35
Felix is presenting our study on open and TEVAR treating dTAA. Great job, Felix!!!
1
4
34
Great job by Felix, presenting the outcomes of TAA or TAAA repair with HCA or aortic clamping at MSTCVS!
3
3
33
It was a great wet lab of aortic annular enlargement (AAE) for practicing surgeons in Michigan hosted by MSTCVS. The rate of AAE in the State of MI is 17% compared to 2-3% nation wide. MSTCVS will have another wet lab soon. More pts have large valves.
I am grateful to Dr.
@BoYangMD
and
@ShinFukuharaMD
for their presentation on novel annular enlargement techniques and for giving me the opportunity to be a participant in this exceptional event
@UMichCTSurgery
0
0
23
2
0
34
Good illustration of the LFT and RFT to understand Y incision aortic annular enlargement
Left and right fibrous trigones and their relationship from the mitral to the aortic valve. Developmentally the aortic and mitral valves are at the same level then the mitral drops. Anchor your partial rings in the trigones not the commissures!
1
16
56
2
3
33
Great teacher first. He trained so many outstanding cardiac surgeons. Without him, I could be where I am now. Many of his trainees have the same thoughts
Esteemed cardiothoracic surgeon & long-time mentor for rising scientists,
@StanfordCTSurg
Dr. Craig Miller retires after 43 yrs at
@StanfordHealth
@StanfordMed
👏 Thanks to Dr. Miller for his leadership, service, & commitment to patient health! Read more
3
15
120
2
3
32
We enlarge the crown shape annulus and root liberally. All my fellows mastered this technique. But I don’t put size 29 in every pt. Some gets 25 or 27 which matches the native annulus of 19-21mm. When the LCA ostium is low, <5 mm, downsize from the largest size by 1 valve size.
3
2
33
Armi first time presented the long-term outcomes of Pts with MPS treated with endovascular fenestration/stenting at AATS as MS1. Great job, Armi!!!!
2
0
31
A lot of to work with our resident and PAs and friends in the wet lab. The joy of teaching!!!!!!
Thank you
@BoYangMD
@GAilawadiMD
@baxter_intl
@sarah_wardCT
and Dr. Patel for spending this time on a Saturday!
#whyumichCTsurgery
1
9
38
1
2
31
Will use excellent illustrations from Sarah Chen, a PGY5 I6 resident at UC Davis, and a medical illustrator for Ann thorac surg and short video clips to explain each step. Welcome discussions and question.
0
6
30
@AortaSurg
Good thing you didn’t take the pt to the OR for open aortic repair. We perform aortic and SMA fenestration and stenting to resolve the malperfusion first, then delayed aortic repair after pt recovered from MOF. Have Saved quite a few with dead bowel.
4
0
27
There are very few women cardiac surgeons in China. Sarah’s story inspired many women in China
In addition, former
@UMichCTSurgery
resident & aortic fellow
@sarah_wardCT
, now faculty
@MHIF_Heart
, gave an amazing talk about women in CT Surgery & early career experience with annular enlargement, including her 1st case as faculty in pt w morbid obesity req redo AVR w/ Y-AAE
1
3
25
0
1
25
Univ of Michigan Frankel Cardiovascular center MI-AORTA join the Walk for Victory to support the Marfan foundation!!!
0
3
26
With "Y" incision/rectangular patch we routine enlarge the aortic annulus by 4 valve sizes. this pt LCA was low, 5 mm, only 3-valve sizes. any annulus<=25 mm should be enlarged to upsize 3-4 valve sizes. otherwise, we reduce annular area by 40-50%. will be presented at AATS 2021
0
3
26
Great work by Jama, Laurent and Gebrine
In the upcoming issue of the Annals of Cardiothoracic Surgery, guest editor
@BoYangMD
, we’ll be sharing some insights into aortic root anatomy and root enlargement techniques. Here a sneak peek.
@GebrineK
@samsaid75
3
21
101
1
1
26
Using transcriptomics really helps micro dissect the change of gene expression of the media of the vessel due to TGFBR1 mutation.
Combining
#GeneEditing
, bioengineered vessel grafts, and stem cells, scientists present a mouse model that faithfully mimics the formation of thoracic aortic aneurysms, which are often seen in patients with
#LoeysDietzSyndrome
.
@BoYangMD
@umichCVC
1
5
11
3
2
25
This comparison is like any other studies: small annulus needing root enlargement VS large annulus that didn’t need root enlargement. Apple to oranges. need show small annulus with or without enlargement. Our study showed in small annuli, AAE improve 6 year survival.
Not all concomitant procedures favors survival. Root enlargement no as easy as thought..
1
1
5
2
3
24
It was a great discovery in our lab using iPSCs and CRISP gene editing to knock in the TGFBR1 mutation in wild type iPSCs and correct the mutations in LDS Pts’ iPSCs!
hiPSC modeling of lineage-specific smooth muscle cell defects caused by TGFBR1A230T variant, and its therapeutic implications for Loeys-Dietz Syndrome
#AHAJournals
@BoYangMD
@umichCVC
0
5
18
2
4
24
IMG036.JPGsame technique for a 5th time redo mechanical valve replacement. annulus was 21 mm after debridement, we put a 27 mm St. Jude valve after root enlargement
2
3
20
Grea work from Ying Yang and Dogukan Mizrak and our lab!!!! Also great support from our patients.
A human aortic aneurysm model using bioengineered vascular grafts reveals insights into the pathogenesis of Loeys-Dietz syndrome
@ScienceTM
@BoYangMD
1
2
4
1
1
22
Great trip, we also learned a lot from our colleagues in China.
After multiple presentations on VSARR, AV repair, & AAE,
@BoYangMD
led a wet lab teaching the Y-incision annular enlargement. The most common valve size in China is 21 mm... 27 & 29s are practically never used. And just like in the US, annular/root enlargement is extremely rare!
1
1
16
0
4
22
@lindaschulteMD
@M_Pompeu_Sa_MD
@KarenMKimMD1
@sarah_wardCT
@Matthew_C_Henn
If the MV annulus is bigger enough, MVR first then Y incision aortic root enlargement to upsize 3-4 valve sizes for AV. Have done a few. Y incision is not affected by MV prosthesis. If MV annulus is small, commando to enlarge both.
0
1
21
Great job by Armi, med student from MSU, who wants to be an cardiac surgeon!!
Researchers used EMERSE to conduct "detailed medical chart review" for the paper, "Contemporary Non-surgical Management of Acute Type A Aortic Dissection: Better Outcomes?"
@KarenMKimMD1
@ShinFukuharaMD
@BoYangMD
0
0
7
0
3
20
@PJSpen1982
PCI pushed surgeons to use LIMA and arterial grafts. TAVR is pushing surgeons to do annular/root enlargment with large valve and root for better hemodynamics and life-time management.
1
0
18
We have dedicated faculty, variety of aortic pathology from the aortic root to femoral artery to train our aortic fellows.
0
5
18
@CristianRosuMD
@sarah_wardCT
@UMichCTSurgery
@UMichSurgery
@GAilawadiMD
We don’t use any reenforcement or any surgical adjuncts. Just 5-0 prolene C-1 needle for all anastomoses. We published our technique and first 100 cases in JTCVS 2017.
2
1
17
Great presentations by Alex and Sarah. So proud of both of them!!!!
We also discussed the structure/length/req of CT training in US & specifically at
@UMichCTSurgery
, where we've been fortunate to be taught & granted autonomy in simple/complex cases by world class mentors, in program that's been 50/50 female/male for the past decade
@GAilawadiMD
1
4
31
0
1
17
Great effort and team work from out lab
Dissecting the Heterogeneity of Human
#ThoracicAorticAneurysm
Using Single-Cell Transcriptomics
A very useful synthesis of scRNAseq literature onSMC & immune cells in🐭👤TAA & AAA
Dr. Dogukan Mizrak, Hao Feng, Bo Yang
@atvbahajournals
2022
@BoYangMD
1
10
36
0
3
17
Excellent job by all the members in the lad, especially Dr. Dogukan Mizrak, a genius in our group and, great collaboration with Eugene Chen
Single-molecule spatial transcriptomics reveals a calcification-related rare smooth muscle cell type in human thoracic aortic aneurysms
@boyangMD
0
8
39
0
2
16
Our great residents team!!!!
Residency team breakfast at the UM staple Angelo’s! Thanks
@GAilawadiMD
!
@UMichCTSurgery
@UMichSurgery
@umichCVC
@ThoracicStudent
@TSRA_official
@AlexBresciaMD
@RyanAJCampagna
@FerrelMeganne
@temilolaoluwa
0
6
33
0
1
16
@GilbertTangMD
@JACCJournals
@djc795
@NimeshDesaiMD
@adnanalkhouli
@HarryDauerman
@KendraGrubb
@mirvatalasnag
To better prepare Pts for future v in v TAVR, a size 25 or larger valve is preferred for all our Pts at initial SAVR!
3
1
15
Great accomplishment, Shinichi!!!
Congratulations to
@ShinFukuharaMD
for his installation as the Deeb Research Professor! It’s a privilege to learn from both of them.
@UMichCTSurgery
@umichCVC
@umichmedicine
@GAilawadiMD
@KarenMKimMD1
@BoYangMD
@abouelela_a
@sarah_wardCT
4
4
51
1
1
12
Our resident, Candis Jones presenting Unicuspid AB repair. Outstanding presentation!!!! Go blue
@KCUngerleiderMD
crushing it at the
#AATS2023
resident case report competition
@BoYangMD
@umichCVC
@UMichCTSurgery
0
1
4
1
1
14
MSRA infected TEVAR stent graft with aorti-pulmonary fistula in a ESRD with chronic type B. Any time we put a hardware into a pt, we subject the pt to life time long risk of lethal infection. We Have to be cautious!!
1
0
14
@georgetolisjr
That’s a fair statement . Surgeons do need to learn how to the aortic annular/root enlargement safely and effectively first just like we learned how to use LIMA for CABG years ago, then it becomes routine.
1
1
13
there were three "letter to editor" from readers and three response from me to discuss this technique. this is the latest one to discuss in situ coronary re-enforcement.
0
0
12
Great job from Tingting, Chelsey, Dogukan, and the team!!!
GATA4 at the intersect of Bicuspid aorticvalve genetics and Endothelial-mesenchymal transition
@boyangMD
0
1
8
1
2
12
I showed this case to leaders in cardiology. Their comments are this is good results. But most surgeons in the US would put a size 19 or 21 for this pt. Not sure that is better than TAVR.
Explanted 23 sapient, enlarged the annulus from 19 to 25. The opening of old TAVR valve was < 1/3 of the new SAVR valve. coronary Ostia were above the SAVR valve. Aortic annular enlargement should be routine in SAVR like LIMA in CABG, especially in redo SAVR after SAVR or TAVR.
15
37
239
2
0
13
@UPMC_CTSurgery
Interesting, at Michigan, our study showed women have better operative and long term survival due less extensive dissection and repair, and being healthier than men.
0
0
10
@GAilawadiMD
@UMichCTSurgery
@umichCVC
@umichmedicine
Thank you all!! We have a great colleagues at UMich, which makes our job a lot more fun!!!
2
0
11
@JakethaGreat419
It was the Michigan team of cardiac surgery, pediatric cardiology, IR, vascular surgery, nursing staff and other staff member working together. We are so glad you recovered so well after the operation. Go blue!!!!
@umichCVC
@GAilawadiMD
0
0
11
@SuguruOhira
@annalsthorsurg
@ctsnetorg
Y incision means the inverted Y shape incision at the aortomitral Curtain. 1/3 of cases reported in the early outcomes in JTCVS were redos. Now we have close to 100 cases with Y incision AAE. 62% had size 29 valve or largest mechanical valve. Smallest was 25 except first case.
1
0
11
Great work from Dr Grubb and colleague
🔥Hot off the press🔥 Read our paper just published in Annals of Cardiothoracic Surgery about overcoming prosthesis-patient mismatch
#PPM
with
#TAVI
#TAVR
#StructuralHeart
🫀
@KendraGrubb
#StephanieTom
@IbrahimSultanMD
@UPMC_CTSurgery
@EmoryCTSurgery
0
8
36
0
1
9
@LuisCastroMD
@ovidiogarciav
@tomcnguyen
@AortaSurg
May not. If our trainees are not ready, it is our fault, not the trainees’
3
1
9
@BobbyYanagawa
@AlexBresciaMD
@sarah_wardCT
@baxter_intl
@GAilawadiMD
@UMichCTSurgery
@umichCVC
@TessaMFWatt
@AATSED
@STS_CTsurgery
@JarredMondonedo
@ChiChiDoNguyen
Any valve smaller than 25 should not be put in a pt since 25 valve has a diameter of the valve orifice of 19-20. That’s the smallest annulus in adults.
1
0
10
Great job by Armi, our medical student, and the team
EMERSE, "coupled with a thorough medical chart review, was used to ensure acute pathology only" in a study on Acute type A intramural hematomas.
@FOrelaru
@ShinFukuharaMD
@BoYangMD
0
0
3
0
1
10
@LuisCastroMD
@ovidiogarciav
@tomcnguyen
@AortaSurg
@M_Pompeu_Sa_MD
@Abedeanda
Great job. We stopped using homograft for endocarditis 20 years ago due to severe calcification and difficult for redo. We have been using freestyle valve. 5-8% op mortality in Pts with root abscess. Paper was published in JTCVS. Reinfection had been very low.
3
3
10
@DrMoritzWvB
@umichCVC
@GAilawadiMD
@QasimAbri
This is a very important modification of aortotomy closure in Y incision root enlargement to prepare Pts for future VIV TAVR.
0
1
9
this is a case after type A repair with bioglue at outside hospital. pt developed proximal and distal peusoaneurysm. we perform two stage operation to fix both. See details in the same paper.
0
1
8
@AlexBresciaMD
@sarah_wardCT
@baxter_intl
@GAilawadiMD
@UMichCTSurgery
@umichCVC
@TessaMFWatt
@AATSED
@STS_CTsurgery
@JarredMondonedo
@ChiChiDoNguyen
Great job!! Alex!!! No more small valves for our Pts.
1
0
9
Great team work, go blue!!!!
And…IMPROVE-AD IS UP AND RUNNING! First patient enrolled. THANK YOU AND CONGRATULATIONS TO
@BoYangMD
and entire team at U of Michigan 🙌
@KougiasP
@manesh_patelMD
1
5
17
1
1
9
Remind me of the life as a resident. It is a very special time!!!
I am beyond happy to be at a program with these people. Check out what makess
@UMichCTSurgery
so special—>
0
2
19
0
1
9
@DambuzaNyamande
Great work. All residents and fellows at U Michigan have learned and mastered this technique too. It is a requirement of graduation
0
0
9
@MReardon19
@OuzounianMD
@hahn_rt
@KendraGrubb
@JJahanyarMDPhD
@nickburrisMD
@DawnHuiMD
@igeorge1975
@marko_boskovski
@M_Pompeu_Sa_MD
this is the link to the issue in May in ACS, papers, presentations, videos by experts in TAVR-SAVR trials, PPM, valve size, root anatomy, SVD, techniques of annular enlargement, pitfalls and updates, illustrations of Y-incision. It’s open to everyone
1
16
54
2
2
9
@DrZeigler1
Great work. If the Y incision reaches the area below the nadirs, cutting into left and right fibrous trigones, the patch size could be 3 - 3.5 cm. Then should be able to increase from 19 to 25 or 27 valve.
0
0
9
@APolancoMD
@ChrisMalaisrie
@GChadHughesMD
@DrZeigler1
@drraycleemd
Great approach. Another approach we used is intrathoracic R subclavian A cannulation ( JTCVS tech, 2021) I use it routinely if innominate A and carotid A are dissected. Our study shows both central cannulation and arch branch vessel cannulation are good tools (JTCVS Tech 2022)
0
0
9
@clubby73
@ovidiogarciav
@DrJayMohan
@LuisCastroMD
@MusaSharkawiMD
@tomcnguyen
@DVDaniels
If we decide this old and frail lady is a surgical candidate and put through open sternotomy, CPB and cardiac arrest for the AVR, I think we should take extra 10-15 minutes to enlarge her root to give her the most benefit of SAVR assuming the surgeon is familiar with the tech
5
3
8
@DrMoritzWvB
@hamzanady
@tssmn
@QasimAbri
@DeBakeyCVedu
@HMethodistCV
@AlanLumsdenMD
@EricRoselliMD
@FaisalBakaeen
@LarsSvenssonMD
@RowseMD
@pomyers
@GilbertTangMD
Very nice! Glad it works for you. We will have wet labs of this technique soon for cardiac surgeons in Michigan sponsored by Michigan State Thoracic Cardiovascular Surgery ( MSTCVS) collaborative
0
1
8
@LuisCastroMD
@ovidiogarciav
@tomcnguyen
@DVDaniels
Great work, Luis. This type of cases will be our routine in the future for cardiac surgeons. Job security. TAVR in SAVR is always limited by the initial SAVR valve.
1
2
8
@georgetolisjr
After AAE, the valve is perpendicular to the blood flow and not tilt . since pts with AV stenosis have normal basal ring and LVOT, the gradients are normal. if we upsize valve by 3-4 valve sizes, the opening of the valve is equal or large than basal, then no limiting factor
2
0
8
@LuisCastroMD
@DrZeigler1
@M_Pompeu_Sa_MD
@CristianRosuMD
@AspiringCTS
@ovidiogarciav
Great, I debride all calcium of aortomitral curtain and MV ant leaflet. If the MV gets too thin , I reenforce MV with autologous pericardial patch, then do the Y incision annular enlargement.
1
1
8