Fleissner Felix, Molitoris Ulrich, Shrestha Malakh, Martens Andreas
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
Department of Anaesthesiology, Hannover Medical School, Hannover, Germany.
Interact Cardiovasc Thorac Surg. 2015 Mar;20(3):436-8. doi: 10.1093/icvts/ivu429. Epub 2014 Dec 21.
In recent years, sutureless aortic valves have grown in popularity. As these valves do not need to be anchored with sutures, shorter cardiac ischaemia and extracorporeal circulation times can potentially be achieved. In addition, the absence of a sewing ring in these valves results in a greater effective orifice area for any given size. Postoperative outcome may be improved using sutureless valves especially when combined with minimally invasive surgical techniques. However, sutureless aortic valves present unique surgical risks. We report 2 cases of delayed distortion of a sutureless aortic valve stent resulting in paravalvular leakage and increased transvalvular gradients. One patient underwent a reoperation with an aortic valve replacement using a standard biological aortic valve, the other patient was treated with balloon dilatation of the aortic valve stent.
近年来,无缝合主动脉瓣越来越受欢迎。由于这些瓣膜无需用缝线固定,因此有可能缩短心脏缺血时间和体外循环时间。此外,这些瓣膜没有缝合环,对于任何给定尺寸,其有效瓣口面积更大。使用无缝合瓣膜尤其是与微创外科技术相结合时,术后结果可能会得到改善。然而,无缝合主动脉瓣存在独特的手术风险。我们报告2例无缝合主动脉瓣支架延迟变形导致瓣周漏和跨瓣压差增加的病例。1例患者使用标准生物主动脉瓣进行主动脉瓣置换再次手术,另1例患者接受主动脉瓣支架球囊扩张治疗。