46769 Istituto Clinico Sant'Ambrogio, Milano, Italy.
70401 Libin Cardiovascular Institute and University, Calgary, AB, Canada.
Innovations (Phila). 2021 May-Jun;16(3):273-279. doi: 10.1177/1556984521999323. Epub 2021 Apr 18.
To report early and midterm results registry of patients undergoing repeated aortic valve replacement (RAVR) with sutureless prostheses from an international prospective registry (SURE-AVR).
Between March 2011 and June 2019, 69 patients underwent RAVR with self-expandable sutureless aortic bioprostheses at 22 international cardiac centers.
Overall mortality was 2.9% with a predicted logistic EuroSCORE II of 10.7%. Indications for RAVR were structural valve dysfunction (84.1%) and infective prosthetic endocarditis (15.9%) and were performed in patients with previously implanted bioprostheses (79.7%), mechanical valves (15.9%), and transcatheter valves (4.3%). Minimally invasive approach was performed in 15.9% of patients. Rate of stroke was 1.4% and rate of early valve-related reintervention was 1.4%. Overall survival rate at 1 and 5 years was 97% and 91%, respectively. No major paravalvular leak occurred. Rate of pacemaker implantation was 5.8% and 0.9% per patient-year early and at follow-up, respectively. The mean transvalvular gradient at 1-year and 5-year follow-up was 10.5 mm Hg and 11.5 mm Hg with a median effective orifice area of 1.8 cmand 1.8 cm, respectively.
RAVR with sutureless valves is a safe and effective approach and provides excellent clinical and hemodynamic results up to 5 years.
报告一项国际性前瞻性注册研究（SURE-AVR）中接受无缝线瓣膜重复主动脉瓣置换术（RAVR）患者的早期和中期结果。
2011 年 3 月至 2019 年 6 月，在 22 个国际心脏中心，69 例患者接受了自膨式无缝线生物主动脉瓣的 RAVR。
总体死亡率为 2.9%，预测的 logistic EuroSCORE II 为 10.7%。RAVR 的适应证为结构性瓣膜功能障碍（84.1%）和感染性人工瓣膜心内膜炎（15.9%），并在先前植入生物瓣（79.7%）、机械瓣（15.9%）和经导管瓣膜（4.3%）的患者中进行。微创方法在 15.9%的患者中进行。卒中和早期瓣膜相关再干预的发生率分别为 1.4%和 1.4%。1 年和 5 年的总生存率分别为 97%和 91%。无重大瓣周漏发生。起搏器植入率分别为每例患者每年 5.8%和 0.9%，早期和随访时。1 年和 5 年随访时的平均跨瓣梯度分别为 10.5mmHg 和 11.5mmHg，中位有效瓣口面积分别为 1.8cm 和 1.8cm。
无缝线瓣膜的 RAVR 是一种安全有效的方法，可提供出色的临床和血液动力学结果，最长可达 5 年。
