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使用Perceval无缝合生物假体进行主动脉瓣置换术后早期主动脉夹层。

Early aortic dissection after aortic valve replacement with a Perceval sutureless bioprosthesis.

作者信息

Falcetta Giosuè, Pratali Stefano, Ravenni Giacomo, Bortolotti Uberto

机构信息

Section of Cardiac Surgery, Cardiothoracic and Vascular Department, University Hospital of Pisa, Via Paradisa, 2, 56124 Pisa, Italy.

出版信息

Indian J Thorac Cardiovasc Surg. 2019 Jul;35(3):510-512. doi: 10.1007/s12055-018-0675-6. Epub 2018 Apr 14.

Abstract

We report a patient who developed ascending aorta dissection after aortic valve replacement with a Perceval sutureless pericardial bioprosthesis, a previously not reported complication with this device. At reoperation, the intimal tear was located at the aortotomy suture line; the tips of the nitinol stent were far from the aortic lesion which therefore was not attributable to the presence of this specific prosthetic model. Nevertheless, a previous report of aortic dissection due to erosion of the aortic wall by the strut of a transcatheter prosthesis may raise the suspicion that such complication could also occur with sutureless prostheses of similar design.

摘要

我们报告了一例患者,其在使用Perceval无缝线心包生物瓣膜进行主动脉瓣置换术后发生升主动脉夹层,这是该装置此前未报告过的并发症。再次手术时,内膜撕裂位于主动脉切开缝合线处;镍钛诺支架的尖端远离主动脉病变,因此该病变并非归因于这种特定假体模型的存在。然而,此前有关于经导管假体支柱侵蚀主动脉壁导致主动脉夹层的报告,这可能会引发怀疑,即类似设计的无缝线假体也可能发生此类并发症。

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本文引用的文献

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A supra-annular malposition of the Perceval S sutureless aortic valve: the 'χ-movement' removal technique and subsequent reimplantation.
Interact Cardiovasc Thorac Surg. 2012 Aug;15(2):280-1. doi: 10.1093/icvts/ivs148. Epub 2012 Apr 25.
8
Risk of aortic dissection after aortic valve replacement.主动脉瓣置换术后主动脉夹层的风险。
Am J Cardiol. 1993 Nov 1;72(14):1043-7. doi: 10.1016/0002-9149(93)90860-f.

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