Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 30:43-32:59 At the Cleveland Clinic in 2020 we did 1,381 operations only a couple percent lower than 2019. We were affected by the pandemic but fortunately peop…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 28:48-30:42 I showed you the quick survival curve from our series but we looked at 178 patients, who underwent that David's re-implantation procedure in our ins…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 28:00-28:47 Hopefully we'll find other ways to guide us besides just the size of the aorta but what I think is important to also understand is that survival is …

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 26:38-27:59 Unfortunately, you know, the guideline of how to do this is based on the size but we see in this data here that a lot of aortas will still develop, …

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 25:16-26:37 So when someone has an aortic dissection you can come back if you were looking away. 目をそらしていた方は、もう画面を見ても構いません。 When someone…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 23:22-25:15 What does this operation look like? Well, we sew right to the inside of the heart so we're not counting on any of that aortic tissue down in the roo…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 22:54-23:21 How do we do with these operations? では、自己弁温存大動脈基部手術の成績について説明したいと思います。 Well, survival after David's root replacement…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 19:52-22:53 So what do we do when we find a patient has an aortic root aneurysm? Well, there's kind of four commonly, more commonly performed operations that I'…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 17:45-19:51 But I want the audience to understand especially those of you who may have some fear about all this. The more sometimes the more you learn it's kind…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 15:53-17:45 Well, why is it that the aortic root is involved when in patients with connective tissue disorder? Honestly I don't know, I don't know exactly why b…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 13:38-15:52 So we know that thoracic aortic disease is commonly familial. You everyone in this audience, I'm sure, knows a lot about Marfan, Loeys-Dietz, Ehlers…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 11:42-13:37 And so that occurs by a process we call maladaptive remodeling. 中膜の組織が壊れるプロセスは不適応リモデリングと呼ばれています。 The picture on the …

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 8:56-11:41 So why do aortic aneurysms and aortic dissections happen? Pathophysiology, what's the cause? Well, what happens before someone has an aortic dissecti…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 8:22-8:55 We know that aortic disease can be fatal. 大動脈疾患が命に関わることはよくご存知だと思います。 The picture on the left is an aortic root aneurysm. You…

Aortic Root Surgery in Connective Tissue Conditions - Surgery Series (2/10/21) 6:19-8:21 I know that many of you in the audience, of course, understand the aorta but just to quickly review the anatomy. I think it's important to understand …

Mitral Valve Surgery - Surgery Series, 2/2/21 58:48-59:22 Q:Somebody's asking, "Is it almost certain that someone isn't having any stenosis or regurgitation with the mitral valve, but they eventually will if they have Marfan or Loeys-Dietz…

Mitral Valve Surgery - Surgery Series, 2/2/21 57:59-58:45 Q:What's the, what's the difference between mitral and tricuspid valve prolapse? Different valves? 三尖弁逸脱と僧帽弁逸脱の違いは何ですか？三尖弁と僧帽弁は違う弁ですか？ A:Yes, diff…

Mitral Valve Surgery - Surgery Series, 2/2/21 57:06-57:51 Q:So what are situations then that you'd consider using minimally invasive procedures? 低侵襲手術が適しているのはどのような場合でしょうか？ A: Well, I, I would say isolated mitral v…

Mitral Valve Surgery - Surgery Series, 2/2/21 55:39-57:04 Q:So there's a lot of questions where people are asking about mitral valve surgery and either concurrent or future aortic valve or any other aortic replacement surgery. Is there an …

Mitral Valve Surgery - Surgery Series, 2/2/21 54:43-55:22 Q:What's the, if somebody's just having a mitral valve repair or placement, what's the recovery rate of surgery and the aftercare? 僧帽弁の修復手術や置換手術を受けた後、回復まではど…

Mitral Valve Surgery - Surgery Series, 2/2/21 53:36-54:41 Q:What if the oh you talked a lot about the the ring. What happens if it leaks? Does somebody need to go into another operation? 手術で人工リングを縫い付けた後にリークが生じた場合は…

Mitral Valve Surgery - Surgery Series, 2/2/21 50:23-52:52 Lastly I'm just going to mention this because I know there were some questions this mitral clip. This, this is this same general principle of that alfieri stitch that I mentioned wh…

Mitral Valve Surgery - Surgery Series, 2/2/21 48:37-50:23 Now one question that comes up too is what, what incision, what about minimally invasive surgery. Well, you know, the conventional operation is to divide the breastbone in the middl…

Mitral Valve Surgery - Surgery Series, 2/2/21 44:52-48:36 I'm not going to go in any detail about how mitral valves are repaired, but, but generally the, the issue is that the annulus is very dilated so the flaps are pulled apart from each…

Mitral Valve Surgery - Surgery Series, 2/2/21 42:37-44:52 Amy's already talked about repair versus replacement and I just want to stress that that over the years we have appreciated that if, if it's technically feasible and it's successful…

Roanne Weisman、The Marfan Foundationボランティアライティングチーム GenTAC会長のKim Eagle医師（ミシガン大学）とThe Marfan Foundation最高科学責任者であるJosephine Grima博士は、2020年11月、The Marfan Foundationの新設部門であるGenTAC Alliance…

Mitral Valve Surgery - Surgery Series, 2/2/21 38:48-42:36 I think most of you are familiar with the options for artificial valves. Both of these are artificial whether it's tissue or mechanical. 大部分の皆さんは、人工弁の種類についてご存知…

Mitral Valve Surgery - Surgery Series, 2/2/21 36:49-38:31 Lastly there are special considerations that we have to think about for, for people who have Marfan syndrome and related conditions when we're thinking about heart surgeries. 最後に…

Mitral Valve Surgery - Surgery Series, 2/2/21 34:34-36:49 So considerations that you make when you're, when you're deciding about surgery so clearly repair is the goal just like it is now with the aortic valve but you always have to talk a…

Mitral Valve Surgery - Surgery Series, 2/2/21 31:56-34:33 For many years the debate, I won't get into too much detail, but the debate had been repair of the mitral valve versus replacement and is repair gonna last and so many, many studies…