Glauber Mattia, Miceli Antonio, Di Bacco Lorenzo
Department of Minimally Invasive Cardiac Surgery, Istituto Clinico S. Ambrogio, Gruppo San Donato, Milano, Italy.
Ann Cardiothorac Surg. 2020 Sep;9(5):417-423. doi: 10.21037/acs-2020-surd-23-intuity.
In the last two decades, sutureless (Perceval, Livanova PLC, London, UK) and rapid deployment (INTUITY Elite, Edwards Lifesciences, Irvine, CA, USA) valves were introduced to the market as an innovative alternative to traditional valves for patients needing aortic valve replacement (AVR). These devices have been used and studied extensively across these fifteen years, and have proven to be a valid alternative treatment option compared to sutured biological valves, particularly helpful in minimally invasive cardiac surgery, and an almost curative treatment to patients with intermediate to high surgical risk, filling the gap between transcatheter and traditional AVR. However, both sutureless and rapid deployment valves require special steps for implantation, and also a learning curve. Proper specific training to all surgical team members is required as mandatory by the manufacturers. The aim of this review article is to provide cardiac surgeons with a thorough guide on the implantation technique from A to Z, for each of these two prosthetic devices. In this second part of our review article, we will focus on the INTUITY Elite valve.
在过去二十年中,无缝合瓣膜(Perceval,Livanova PLC,英国伦敦)和快速植入瓣膜(INTUITY Elite,爱德华生命科学公司,美国加利福尼亚州欧文)作为传统瓣膜的创新替代品,被推向市场,用于需要进行主动脉瓣置换术(AVR)的患者。在这十五年间,这些装置得到了广泛应用和研究,与缝合生物瓣膜相比,已被证明是一种有效的替代治疗选择,尤其在微创心脏手术中很有帮助,对于手术风险中到高的患者几乎是一种治愈性治疗,填补了经导管主动脉瓣置换术和传统主动脉瓣置换术之间的空白。然而,无缝合瓣膜和快速植入瓣膜都需要特殊的植入步骤,并且存在学习曲线。制造商要求必须对所有手术团队成员进行适当的专项培训。这篇综述文章的目的是为心脏外科医生提供一份关于这两种人工瓣膜从A到Z的植入技术的全面指南。在我们综述文章的第二部分,我们将聚焦于INTUITY Elite瓣膜。