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Ascaso MAuthorSandoval EAuthorQuintana EAuthor

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January 8, 2025
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Root-commando operation for multivalvular endocarditis and pericardiectomy.

Publicated to:Multimedia Manual Of Cardiothoracic Surgery : Mmcts / European Association For Cardio-Thoracic Surgery. 2020 - 2020-09-01 2020(), DOI: 10.1510/mmcts.2020.052

Authors: Fernández-Cisneros A; Ascaso M; Rovira I; Sandoval E; Quintana E

Affiliations

- Author
Cardiovascular Surgery Department. Hospital Clínic Barcelona, Spain. - Author
Hospital Clínic de Barcelona Cardiovascular Surgery Department University of Barcelona Medical School. - Author

Abstract

This video tutorial  presents the reconstruction of the intervalvular fibrosa and a triple valve replacement, due to prosthetic valve endocarditis, in a patient with previous chest irradiation and bicuspid aortic valve replacement. Constrictive pericarditis was also present since the original operation. A detailed step-by-step demonstration of the reconstruction of the intervalvular fibrosa and debridement of extensive prosthetic valve endocarditis with paravalvular root abscess are provided.  A secondary sternotomy was performed and, in the process, the ascending aorta was injured, with associated life-threatening bleeding. Manual compression was applied while peripheral cannulation and cardiopulmonary bypass were started. The bleeding was controlled with cooling and circulatory arrest and the ascending aorta was replaced with a Dacron graft. The intervalvular fibrosa was reconstructed using a folded pericardial patch.  Aortic root replacement with a cryopreserved homograft was performed and the mitral and tricuspid valves were replaced with tissue valve prostheses. A complete pericardiectomy was performed. The chest was left packed with cotton due to diffuse bleeding. At the time of the delayed chest closure, a permanent epicardial pacemaker was implanted.

Keywords

AortaEndocarditis, bacterialHeart valve prosthesisHeart valve prosthesis implantationHeart valvesHumansIntraoperative complicationsMaleMiddle agedPericardiectomyPericarditis, constrictiveProsthesis-related infectionsReoperationTreatment outcomeVascular grafting

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Multimedia Manual Of Cardiothoracic Surgery : Mmcts / European Association For Cardio-Thoracic Surgery, Q4 Agency Scopus (SJR), its regional focus and specialization in Medicine (Miscellaneous), give it significant recognition in a specific niche of scientific knowledge at an international level.

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-06:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 22 (PlumX).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Quintana Obrador, Eduardo).