Vendramin Igor, Lechiancole Andrea, Piani Daniela, Nucifora Gaetano, Benedetti Giovanni, Sponga Sandro, Muser Daniele, Bortolotti Uberto, Livi Ugolino
Cardiothoracic Department, University Hospital of Udine, 33100 Udine, Italy.
Cardiac Imaging Unit, NorthWest Heart Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK.
J Cardiovasc Dev Dis. 2021 Jun 25;8(7):74. doi: 10.3390/jcdd8070074.
Sutureless and rapid-deployment bioprostheses have been introduced as alternatives to traditional prosthetic valves to reduce cardiopulmonary and aortic cross-clamp times during aortic valve replacement. These devices have also been employed in extremely demanding surgical settings, as underlined in the present review. Searches on the PubMed and Medline databases aimed to identify, from the English-language literature, the reported cases where both sutureless and rapid-deployment prostheses were employed in challenging surgical situations, usually complex reoperations sometimes even performed as bailout procedures. We have identified 25 patients for whom a sutureless or rapid-deployment prosthesis was used in complex redo procedures: 17 patients with a failing stentless bioprosthesis, 6 patients with a failing homograft, and 2 patients with the failure of a valve-sparing procedure. All patients survived reoperation and were reported to be alive 3 months to 4 years postoperatively. Sutureless and rapid-deployment bioprostheses have proved effective in replacing degenerated stentless bioprostheses and homografts in challenging redo procedures. In these settings, they should be considered as a valid alternative not only to traditional prostheses but also in selected cases to transcatheter valve-in-valve solutions.
无缝合和快速部署生物假体已作为传统人工瓣膜的替代方案被引入，以减少主动脉瓣置换期间的心肺和主动脉阻断时间。如本综述所述，这些装置也已用于要求极高的手术环境中。在PubMed和Medline数据库中进行检索，旨在从英文文献中找出在具有挑战性的手术情况下使用无缝合和快速部署假体的报道病例，这些情况通常是复杂的再次手术，有时甚至作为紧急补救手术进行。我们确定了25例在复杂再次手术中使用无缝合或快速部署假体的患者：17例无支架生物假体功能失效的患者，6例同种异体移植物功能失效的患者，以及2例保留瓣膜手术失败的患者。所有患者再次手术后均存活，据报道术后3个月至4年仍存活。在具有挑战性的再次手术中，无缝合和快速部署生物假体已被证明在替换退化的无支架生物假体和同种异体移植物方面是有效的。在这些情况下，它们不仅应被视为传统假体的有效替代方案，而且在某些选定的病例中也应被视为经导管瓣中瓣解决方案的有效替代方案。
