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新一代生物瓣主动脉瓣置换术后的早期结果。

Early Results after Aortic Valve Replacement Using Last Generation Bioprosthetic Aortic Valve.

机构信息

Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bochum, Germany.

出版信息

Heart Surg Forum. 2021 Nov 29;24(6):E598-E962. doi: 10.1532/hsf.4189.

Abstract

INTRODUCTION

Few data are available about the newest generation surgical bioprosthesis. We aimed to evaluate early clinical and hemodynamic outcomes after using the INSPIRIS RESILIA aortic valve (Edwards Lifesciences, Irvine, California, USA).

METHODS

Between July 2018 and April 2021, 80 patients underwent aortic valve replacement receiving the INSPIRIS RESILIA aortic valve at our institution. Primary outcomes were the composite of early mortality, stroke, and myocardial infarction. Secondary outcomes were hemodynamic performances of the valve, paravalvular leakage, and new pacemaker implantation.

RESULTS

The mean age of the study population was 60.6 ± 8.3 years. The mean Society of Thoracic Surgery-Predicted Risk of Mortality score was 2.9 ± 1.7%. In 43.7% of the patients, concomitant surgery was performed. The in-hospital mortality, all-stroke, and myocardial infarction rates were 2.5%, 1.2%, and 1.2%, respectively. No valve was explanted and no redo was performed. The mean postoperative trans-prosthetic gradient at discharge was 10.2 ± 4.1 mm Hg. There was no need for new pacemaker implantation. We registered only two cases with minimal (trace) paravalvular leakage.

CONCLUSION

The use of the INSPIRIS RESILIA aortic valve in a young, low-risk population is safe and associated with very good early clinical and hemodynamic outcomes.

摘要

简介

关于最新一代外科生物瓣的数据很少。我们旨在评估使用 INSPIRIS RESILIA 主动脉瓣(爱德华兹生命科学公司,加利福尼亚州欧文,美国)后的早期临床和血液动力学结果。

方法

在 2018 年 7 月至 2021 年 4 月期间,我们医院为 80 名患者进行了主动脉瓣置换术,使用 INSPIRIS RESILIA 主动脉瓣。主要结局是早期死亡率、中风和心肌梗死的综合指标。次要结局是瓣膜的血液动力学性能、瓣周漏和新起搏器植入。

结果

研究人群的平均年龄为 60.6 ± 8.3 岁。平均胸外科医师学会预测死亡率评分(Society of Thoracic Surgery-Predicted Risk of Mortality score)为 2.9 ± 1.7%。在 43.7%的患者中,同时进行了伴随手术。院内死亡率、全中风和心肌梗死发生率分别为 2.5%、1.2%和 1.2%。没有瓣膜被取出,也没有进行再次手术。出院时的平均跨瓣压差为 10.2 ± 4.1mmHg。没有需要新的起搏器植入。我们仅登记了两例轻微(微量)瓣周漏的病例。

结论

在年轻、低危人群中使用 INSPIRIS RESILIA 主动脉瓣是安全的,并且与非常好的早期临床和血液动力学结果相关。

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