Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Hufelandstraße 55, 45122 Essen, Germany.
Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany.
Medicina (Kaunas). 2023 Jun 11;59(6):1126. doi: 10.3390/medicina59061126.
: Sutureless aortic valve prostheses have presented favorable hemodynamic performance while facilitating minimally invasive access approaches. As the population ages, the number of patients at risk for aortic valve reoperation constantly increases. The aim of the present study is to present our single-center experience in sutureless aortic valve replacement (SU-AVR) in reoperations. : The data of 18 consecutive patients who underwent SU-AVR in a reoperation between May 2020 and January 2023 were retrospectively analyzed. : The mean age of the patients was 67.9 ± 11.1 years; patients showed a moderate-risk profile with a median logistic EuroSCORE II of 7.8 (IQR of 3.8-32.0) %. The implantation of the Perceval S prosthesis was technically successful in all patients. The mean cardiopulmonary bypass time was 103.3 ± 50.0 min, and the cross-clamp time was 69.1 ± 38.8 min. No patients required a permanent pacemaker implantation. The postoperative gradient was 7.3 ± 2.4 mmHg, and no cases of paravalvular leakage were observed. There was one case of intraprocedural death, while the thirty-day mortality was 11%. : Sutureless bioprosthetic valves tend to simplify the surgical procedure of a redo AVR. By maximizing the effective orifice area, sutureless valves may present an important advantage, being a safe and effective alternative not only to traditional surgical prostheses but also to transcatheter valve-in-valve approaches in select cases.
: 无缝线主动脉瓣假体具有良好的血液动力学性能,同时便于微创入路。随着人口老龄化,需要主动脉瓣再次手术的患者数量不断增加。本研究旨在介绍我们中心在再次手术中进行无缝线主动脉瓣置换术(SU-AVR)的经验。: 回顾性分析了 2020 年 5 月至 2023 年 1 月期间在再次手术中接受 SU-AVR 的 18 例连续患者的数据。: 患者的平均年龄为 67.9 ± 11.1 岁;患者具有中度风险特征,中位逻辑 EuroSCORE II 为 7.8(3.8-32.0)%。所有患者的 Perceval S 假体植入均获得技术成功。体外循环时间平均为 103.3 ± 50.0 分钟,主动脉阻断时间为 69.1 ± 38.8 分钟。无患者需要植入永久性起搏器。术后梯度为 7.3 ± 2.4 mmHg,未观察到瓣周漏。有 1 例术中死亡,30 天死亡率为 11%。: 无缝线生物瓣倾向于简化再次 AVR 的手术程序。通过最大化有效瓣口面积,无缝线瓣膜可能具有重要优势,不仅是传统外科假体的安全有效替代,在某些情况下也是经导管瓣膜内置换术的有效替代。