Raickovic Tatjana, Zivkovic Igor, Ragus Tatjana, Tomic Slobodan, Vukovic Petar, Nezic Dusko, Peric Miodrag, Micovic Slobodan
Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia.
Department of Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia.
Kardiochir Torakochirurgia Pol. 2020 Mar;17(1):20-23. doi: 10.5114/kitp.2020.94186. Epub 2020 Apr 8.
Surgical treatment of the aortic valve represents the gold standard, and thus aortic valve replacement (AVR) is one of the most commonly performed cardiac operations.
To evaluate the early outcome of aortic valve replacement with the Perceval S sutureless aortic bioprosthesis.
This was a retrospective analysis of 24 patients (mean age: 71 ±5 years), who underwent aortic valve replacement with a Perceval S valve. Concomitant coronary artery bypass grafting (CABG) was performed in 9 patients. Patients were evaluated preoperatively, at hospital discharge, and once during follow-up.
A total of 15 of 24 patients underwent isolated sutureless aortic valve replacement (mean aortic cross-clamp time: 60 ±14 minutes; mean bypass time: 90 ±23 minutes). Coronary bypass grafting was performed in 9 patients (mean aortic cross-clamp time: 78 ±23 minutes; mean bypass time: 111 ±31 minutes). Hospital mortality was nil. Mean and peak transvalvular pressure gradients were 10 ±2 mm Hg and 21 ±3 mm Hg at follow-up, respectively. Moderate or severe aortic regurgitation did not develop in any patients during the follow-up period. No valve thrombosis, thromboembolic events, or structural valve deterioration were observed.
In our experience with sutureless aortic valve replacement, the surgical procedure is shown to be safe. The early haemodynamic performance seems favourable. By shortening the aortic cross-clamp and bypass times we can notice advantages, especially in high-risk patients. Minimally invasive access seems to be facilitated. Larger studies are needed to confirm our data and determine the long-term durability of the Perceval S sutureless bioprosthesis.
主动脉瓣的外科治疗是金标准,因此主动脉瓣置换术(AVR)是最常开展的心脏手术之一。
评估使用Perceval S无缝合主动脉生物假体进行主动脉瓣置换术的早期结果。
这是一项对24例患者(平均年龄:71±5岁)的回顾性分析,这些患者接受了Perceval S瓣膜主动脉瓣置换术。9例患者同时进行了冠状动脉旁路移植术(CABG)。对患者进行术前、出院时及随访期间一次的评估。
24例患者中有15例接受了单纯无缝合主动脉瓣置换术(平均主动脉阻断时间:60±14分钟;平均体外循环时间:90±23分钟)。9例患者进行了冠状动脉旁路移植术(平均主动脉阻断时间:78±23分钟;平均体外循环时间:111±31分钟)。住院死亡率为零。随访时平均跨瓣压差和峰值跨瓣压差分别为10±2 mmHg和21±3 mmHg。随访期间无患者发生中度或重度主动脉瓣反流。未观察到瓣膜血栓形成、血栓栓塞事件或瓣膜结构恶化。
根据我们使用无缝合主动脉瓣置换术的经验,该手术显示是安全的。早期血流动力学表现似乎良好。通过缩短主动脉阻断和体外循环时间,我们可以看到优势,尤其是在高危患者中。微创入路似乎更容易实现。需要更大规模的研究来证实我们的数据并确定Perceval S无缝合生物假体的长期耐用性。