Mujtaba Syed Saleem, Ledingham Simon, Shah Asif Raza, Clark Stephen, Pillay Thasee, Schueler Stephan
Department of Cardiothoracic Surgery, Freeman Hospital, Freeman Road, United Kingdom of Great Britain and Northern Ireland.
Braz J Cardiovasc Surg. 2018 Jan-Feb;33(1):8-14. doi: 10.21470/1678-9741-2017-0087.
The aim of this retrospective study is to evaluate the safety and performance of the Perceval sutureless valve in patients undergoing aortic valve replacement. We report the 30-day clinical outcomes of 139 patients.
From January 2014 to December 2016, 139 patients underwent sutureless aortic valve replacement. Their operation notes, National Adult Cardiac Surgery Database and perioperative transoesophageal echocardiography findings were studied retrospectively.
Ninety-two patients underwent isolated aortic valve replacement (group A) with Perceval valve and 47 patients had combined procedures of aortic valve replacement and coronary artery bypass grafting (group B). The patients received a size S (n=23), M (n=39), L (n=42) or XL (n=35) prosthesis. Perceval valve was successfully implanted in 135 (97.1%) patients. Mean cross-clamping time and bypass time were 40 and 63 minutes for isolated cases, while 68 and 107 minutes for combined cases. Three (2.1%) patients died within 30 days. Four patients suffered stroke and 5 patients went into acute renal failure. Median intensive care unit and hospital stay was 2 and 8.5, respectively. Four valves were explanted due to significant paravalvular leak after surgery. Five patients had permanent pacemaker as a result of complete heart block and mean postoperative drainage was 295 mL for isolated case and 457 mL for combined cases. The mean gradient across Perceval valve was 12.5 mmHg while its effective orifice area was 1.5 cm2.
Early postoperative results showed that Perceval valve is safe. Further follow up is needed to evaluate the long-term outcome with this bioprosthesis.
本回顾性研究旨在评估接受主动脉瓣置换术患者使用Perceval无缝合瓣膜的安全性和性能。我们报告了139例患者的30天临床结果。
2014年1月至2016年12月,139例患者接受了无缝合主动脉瓣置换术。对他们的手术记录、国家成人心脏手术数据库和围手术期经食管超声心动图检查结果进行回顾性研究。
92例患者接受了使用Perceval瓣膜的单纯主动脉瓣置换术(A组),47例患者接受了主动脉瓣置换术和冠状动脉旁路移植术的联合手术(B组)。患者接受了尺寸为S(n = 23)、M(n = 39)、L(n = 42)或XL(n = 35)的假体。135例(97.1%)患者成功植入了Perceval瓣膜。单纯病例的平均主动脉阻断时间和体外循环时间分别为40分钟和63分钟,而联合病例分别为68分钟和107分钟。3例(2.1%)患者在30天内死亡。4例患者发生中风,5例患者出现急性肾衰竭。重症监护病房和住院时间的中位数分别为2天和8.5天。4个瓣膜因术后严重瓣周漏而被取出。5例患者因完全性心脏传导阻滞植入了永久性起搏器,单纯病例术后平均引流量为295 mL,联合病例为457 mL。Perceval瓣膜的平均跨瓣压差为12.5 mmHg,有效瓣口面积为1.5 cm²。
术后早期结果表明Perceval瓣膜是安全的。需要进一步随访以评估这种生物假体的长期疗效。