Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia; Department of Anatomy and Developmental Biology, Monash University, Melbourne, Vic, Australia.
Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia; Department of Cardiothoracic Surgery, Monash Health, Melbourne, Vic, Australia.
Heart Lung Circ. 2019 Jun;28(6):970-976. doi: 10.1016/j.hlc.2018.04.287. Epub 2018 May 18.
Sutureless aortic valve replacement (SU-AVR) offers an alternative to traditional aortic valve replacement (AVR) and is becoming widely performed in many hospitals. The aim of the current study was to evaluate the early experience in SU-AVR with the Perceval S bioprosthesis at Monash Medical Centre.
Fifty-two (52) patients who underwent SU-AVR were retrospectively analysed (mean age: 74.8±6.5years). Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30days after surgery, re-admissions and longer term echocardiographic data were collected from the relevant hospital databases.
In isolated SU-AVR, the mean aortic cross-clamp and cardiopulmonary bypass times were 48.8 and 67.8minutes, respectively. There were no deaths within 30days after surgery. Rhythm disturbances developed in 46.2% of patients, with atrial fibrillation (32.7%) and heart block (9.6%) being most common. Mean and peak transaortic gradients reduced from 46.2 and 77.9mmHg preoperatively, to 10.7 and 19.7mmHg at 12 months postoperatively, respectively.
The absence of early mortality and the satisfactory clinical and haemodynamic results demonstrated the overall safety and efficacy of the Perceval S valve. Although sutureless valves seem to be a promising alternative to traditional sutured valves, the high rate of new postoperative rhythm disturbances, particularly heart block, is potentially a concern with SU-AVR.
无缝线主动脉瓣置换术（SU-AVR）为传统主动脉瓣置换术（AVR）提供了一种替代方法，并且在许多医院得到了广泛应用。本研究旨在评估蒙纳士医疗中心使用 Perceval S 生物瓣进行 SU-AVR 的早期经验。
回顾性分析了 52 例接受 SU-AVR 的患者（平均年龄：74.8±6.5 岁）。从相关医院数据库中收集了术前和手术细节、住院时间、术后 30 天内的术后结果、再入院和长期超声心动图数据。
在单纯的 SU-AVR 中，平均主动脉阻断和体外循环时间分别为 48.8 和 67.8 分钟。术后 30 天内无死亡。46.2%的患者出现节律紊乱，最常见的是心房颤动（32.7%）和心脏传导阻滞（9.6%）。平均和峰值跨主动脉梯度从术前的 46.2mmHg 和 77.9mmHg 分别降低至术后 12 个月的 10.7mmHg 和 19.7mmHg。
无早期死亡率和令人满意的临床和血液动力学结果表明，Perceval S 瓣膜具有整体安全性和有效性。尽管无缝线瓣膜似乎是传统缝线瓣膜的一种有前途的替代方法，但术后新出现的节律紊乱，特别是心脏传导阻滞的高发生率，可能是 SU-AVR 的一个潜在问题。
