Valve Center of Excellence, Florida Hospital Cardiovascular Institute, Orlando, Florida.
Department of Surgery and East Carolina Heart Institute, Vidant Medical Center, East Carolina University, Greenville, North Carolina.
Ann Thorac Surg. 2018 Mar;105(3):966-971. doi: 10.1016/j.athoracsur.2017.08.050.
Rapid deployment/sutureless aortic valve replacement is aimed at minimizing the invasiveness of surgical aortic valve replacement. We describe the implantation techniques of a new rapid deployment aortic valve, focusing on its unique and challenging features.
The EDWARDS INTUITY Elite aortic valve (Edwards Lifesciences, Irvine, CA) represents a hybrid between the surgical PERIMOUNT Magna Ease (Edwards Lifesciences) pericardial valve, but with advanced features of the percutaneous SAPIEN valve system (Edwards Lifesciences). A flexible delivery system, with a balloon-expandable subannular frame, facilitates insertion. Important implantation steps include an extended oblique "hockey-stick" aortotomy, symmetrical annular debridement, intra-annular and supra-annular sizing, guiding suture placement, and balloon expansion of the subannular valve frame.
Although this valve provides advantages over conventional aortic valves, its implantation is unique, and special operative considerations must be heeded for optimal outcomes. Implantation requires minimal suturing, enabling smaller incisions. Also, the intra-annular inflow frame may promote improved hemodynamics.
The INTUITY Elite system represents a significant innovation in bioprosthesis technology. It has been shown to be safe and effective, but its implantation requires detailed attention to several unique operative steps.
快速部署/无缝线主动脉瓣置换术旨在将外科主动脉瓣置换术的侵入性降至最低。我们描述了一种新型快速部署主动脉瓣的植入技术，重点介绍其独特且具有挑战性的特点。
EDWARDS INTUITY Elite 主动脉瓣（爱德华生命科学公司，欧文，加利福尼亚州）代表了外科 PERIMOUNT Magna Ease（爱德华生命科学公司）心包瓣与经皮 SAPIEN 瓣膜系统（爱德华生命科学公司）的先进特性之间的混合体。一个灵活的输送系统，带有球囊可扩张的瓣环框架，便于插入。重要的植入步骤包括延长的斜“曲棍球棒”主动脉切开术、对称的瓣环清创术、瓣环内和瓣环上的尺寸测量、引导缝线的放置以及球囊扩张瓣环框架。
尽管这种瓣膜相对于传统主动脉瓣具有优势，但它的植入方式是独特的，需要特别注意手术操作以获得最佳效果。植入需要最少的缝合，可实现更小的切口。此外，瓣环内的流入框架可能会促进更好的血液动力学。
INTUITY Elite 系统是生物假体技术的重大创新。它已被证明是安全有效的，但植入需要详细注意几个独特的手术步骤。
