Aortic Valve Replacement With Biventricular Pacing

This introductory video describes the Gaudiani technique for a straightforward aortic valve replacement. The patient presented with aortic valve regurgitation, as well as a left bundle branch block (LBBB) and an ejection fraction of 25 percent The LBBB causes delayed contraction, promoting the placement of wires in both the right ventricle and left ventricle.  

Two of these wires were placed through the chest tube allowing the left and right ventricle to contract synchronously, which helps improve the ejection fraction. Postoperatively, a cardiologist can assess whether the ejection fraction improves with biventricular pacing, allowing for the planning of a permanent solution. 

The aortic valve replacement was performed with a 25 mm Mosaic valve.  Annulus sutures are demonstrated with both pledgeted and nonpledgeted sutures, alongside some sutures placed from outside the aorta.   

Once the valve was placed, it was thoroughly inspected with a dental mirror to ensure that the valve was down and that the coronary ostia was clear from the valve. A Cor-Knot was then used, and the aorta was closed in a single layer.   

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.