Beyazal Osman Fehmi, Tokatlioglu Tanzer, Basar Veysel, Zengin Ahmet, Yanartas Mehmed
Department of Cardiovascular Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Apr 5;58(1):23-29. doi: 10.14744/SEMB.2024.39112. eCollection 2024.
This study aims to compare the early results of patients who underwent isolated aortic valve replacement (AVR) with supra-annular and intra-annular AVR.
Between 2013 and 2019, 113 patients (77 males; mean age 57.8±16.36 years) who underwent isolated AVR were evaluated. The patients were divided into two groups those who underwent supra-annular (n=59) and intra-annular (n=54) AVR. The most commonly used valves in surgeries St Jude Medical Masters (St. Jude Medical, Minneapolis, MN, USA), (n=35, 30.9%), Sorin Mitroflow (Sorin Group Inc., Mitroflow Division, Canada), (n=32, 28.3%, and Carbomedics Top Hat (Sulzer, Carbomedics, Austin, TX), (n=31, 27.4%).
The cross-clamp (XCL) and cardiopulmonary bypass (CPB) times of the patients who underwent supra-annular AVR were found to be significantly higher than the patients who underwent intra-annular AVR. However, there was no significant difference between the two groups in terms of postoperative adverse events. There was no significant difference between the two groups in the postoperative first-week transthoracic echocardiographic (TTE) findings.
When comparing supra-annular and intra-annular valve positioning results in patients undergoing isolated AVR, no significant difference was found between the groups in terms of postoperative complications, gradient differences in postoperative TTE, and ejection fractions. Supra-annular valve positioning should be considered, especially in patients with small annulus, in the presence of suitable anatomical features. However, this issue needs to be investigated in future prospective studies with more patients.
本研究旨在比较接受单纯主动脉瓣置换术（AVR）时采用瓣环上和瓣环内主动脉瓣置换术患者的早期结果。
2013年至2019年期间，对113例接受单纯AVR的患者（77例男性；平均年龄57.8±16.36岁）进行了评估。患者分为两组，一组接受瓣环上AVR（n = 59），另一组接受瓣环内AVR（n = 54）。手术中最常用的瓣膜为圣犹达医疗马斯特斯瓣膜（美国明尼阿波利斯市圣犹达医疗公司），共35例（30.9%）；索林米特罗弗洛瓣膜（加拿大索林集团公司米特罗弗洛分部），共32例（28.3%）；以及卡波美迪克斯礼帽瓣膜（美国德克萨斯州奥斯汀市苏尔泽卡波美迪克斯公司），共31例（27.4%）。
发现接受瓣环上AVR的患者的主动脉阻断（XCL）时间和体外循环（CPB）时间显著高于接受瓣环内AVR的患者。然而，两组术后不良事件方面无显著差异。两组术后第一周经胸超声心动图（TTE）检查结果无显著差异。
在比较接受单纯AVR患者的瓣环上和瓣环内瓣膜定位结果时，两组在术后并发症、术后TTE梯度差异和射血分数方面未发现显著差异。在存在合适解剖特征的情况下，尤其是对于瓣环较小的患者，应考虑瓣环上瓣膜定位。然而，这一问题需要在未来纳入更多患者的前瞻性研究中进行调查。
