Shala Magjun, Niclauss Lars
Faculty of Medicine and Biology, Lausanne University, Lausanne, Switzerland.
Cardiovascular Department, Division of Cardiovascular Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland.
J Cardiovasc Thorac Res. 2020;12(3):222-226. doi: 10.34172/jcvtr.2020.38. Epub 2020 Aug 26.
The Inspiris Resilia aortic valve® (INSPIRIS) is a pericardial bio-prosthesis with a new sterilization procedure that shows promising results in terms of reduced calcification. The 30-day mortality and morbidity were analyzed, comparing the INSPIRIS implanted between May 2017 and the end of January 2019, with its "predecessor", the Carpentier-Edwards Perimound Magna Ease (ME). Echocardiography was performed one-week after surgery. 125consecutively operated patients were included (59 INSPIRIS, 66 ME). One patient in the ME group died and one patient in the INSPIRIS group had a complicated postoperative course due to right heart failure. Two patients (one INSPIRIS, one ME patient) suffered a perioperative stroke. The hemodynamic evaluation shows an effective reduction of mean transvalvular pressure gradients after surgery in both groups. INSPIRIS tended to have lower trans-prosthetic pressure gradients (9 mm Hg, Interquartile range [IQR] 11-7 mm Hg versus 12 mm Hg, IQR 15-9 mmHg; P = 0.001), reduced trans-prosthetic blood flow acceleration (209 cm/s, IQR 220-190 cm/s versus227 cm/s, IQR 263-191 cm/s; P = 0.003) and increased permeability indices (57%, IQR 67%- 47% versus42%, IQR 48%-38%; P8%; P < 0.001). There are only few clinical data available from INSPIRIS, and the present analysis confirms good results initial postoperatively with a tendency towards possibly improved hemodynamics compared to ME.
英斯派瑞斯瑞思丽主动脉瓣膜®(INSPIRIS)是一种心包生物假体,采用了新的灭菌程序,在减少钙化方面显示出有前景的结果。分析了2017年5月至2019年1月底植入INSPIRIS的患者与它的“前身”卡朋蒂埃 - 爱德华兹Perimound Magna Ease(ME)的30天死亡率和发病率。术后一周进行超声心动图检查。纳入了125例连续接受手术的患者(59例植入INSPIRIS,66例植入ME)。ME组有1例患者死亡,INSPIRIS组有1例患者因右心衰竭术后病程复杂。2例患者(1例INSPIRIS患者,1例ME患者)发生围手术期卒中。血流动力学评估显示两组术后平均跨瓣压差均有效降低。INSPIRIS的跨瓣压差往往更低(9 mmHg,四分位间距[IQR] 11 - 7 mmHg,而ME为12 mmHg,IQR 15 - 9 mmHg;P = 0.001),跨瓣血流加速降低(209 cm/s,IQR 220 - 190 cm/s,而ME为227 cm/s,IQR 263 - 191 cm/s;P = 0.003),通透性指数增加(57%,IQR 67% - 47%,而ME为42%,IQR 48% - 38%;P < 0.001)。关于INSPIRIS的临床数据很少,目前的分析证实术后初期结果良好,与ME相比有血流动力学可能改善的趋势。