Miceli Antonio, Santarpino Giuseppe, Pfeiffer Steffen, Murzi Michele, Gilmanov Daniyar, Concistré Giovanni, Quaini Eugenio, Solinas Marco, Fischlein Theodor, Glauber Mattia
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy; Bristol Heart Institute, Klinikum Nürnberg, Nürnberg, Germany.
University of Bristol, United Kingdom; and Cardiac Surgery, Klinikum Nürnberg, Nürnberg, Germany.
J Thorac Cardiovasc Surg. 2014 Dec;148(6):2838-43. doi: 10.1016/j.jtcvs.2014.02.085. Epub 2014 Mar 4.
The aim of our study was to evaluate the early outcomes and 1-year survival of patients undergoing minimally invasive aortic valve replacement with the Perceval S sutureless valve for severe aortic stenosis.
From March 2010 to March 2013, 281 high-risk patients underwent minimally invasive aortic valve replacement with the Perceval S sutureless valve through either right anterior minithoracotomy (n = 164) or upper ministernotomy (n = 117) at 2 cardiac centers.
The overall in-hospital mortality was 0.7% (2 patients). The overall median cardiopulmonary bypass and crossclamp time was 81 minutes (interquartile range, 68-98) and 48 minutes (interquartile range, 37-60), respectively. Postoperative stroke occurred in 5 patients (1.8%). The incidence of paravalvular leak greater than 1 of 4 and atrioventricular block requiring pacemaker implantation was 1.8% (5 patients) and 4.2% (12 patients), respectively. No migration occurred, and the mean postoperative gradient was 13 ± 4 mm Hg. At a median follow-up of 8 months (interquartile range, 4-14), the overall survival was 90%.
Minimally invasive aortic valve replacement with the Perceval S sutureless valve in high-risk patients is a safe and reproducible procedure associated with excellent hemodynamic results, postoperative outcomes, and 1-year survival.
我们研究的目的是评估采用Perceval S无缝合瓣膜行微创主动脉瓣置换术治疗重度主动脉瓣狭窄患者的早期疗效和1年生存率。
2010年3月至2013年3月，281例高危患者在2个心脏中心通过右前小切口（n = 164）或上段胸骨旁小切口（n = 117）采用Perceval S无缝合瓣膜行微创主动脉瓣置换术。
总体住院死亡率为0.7%（2例患者）。总体体外循环和主动脉阻断时间中位数分别为81分钟（四分位间距，68 - 98）和48分钟（四分位间距，37 - 60）。术后5例患者（1.8%）发生卒中。瓣周漏大于4级中的1级以及需要植入起搏器的房室传导阻滞发生率分别为1.8%（5例患者）和4.2%（12例患者）。未发生瓣膜移位，术后平均跨瓣压差为13±4 mmHg。中位随访8个月（四分位间距，4 - 14）时，总体生存率为90%。
在高危患者中采用Perceval S无缝合瓣膜行微创主动脉瓣置换术是一种安全且可重复的手术，具有优异的血流动力学结果、术后疗效和1年生存率。
