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在患有感染性心内膜炎或主动脉瓣关闭不全的复杂患者中快速部署主动脉瓣植入术。

Rapid deployment aortic valve implantation in complex patients with infective endocarditis or aortic valve insufficiency.

作者信息

Benke Kálmán, Bánhegyi Viktor, Korca Edina, Veres Gábor, Yakobus Yuliana, Matin Meradjoddin, Szabó Gábor

机构信息

Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

Department of Cardiac Surgery, Martin-Luther University Halle-Wittenberg, Halle an der Saale, Germany.

出版信息

J Cardiothorac Surg. 2024 Jul 16;19(1):452. doi: 10.1186/s13019-024-02967-6.

Abstract

BACKGROUND

New prosthetic valves and surgical approaches that shorten operation time and improve the outcome of patients with aortic valve (AV) infective endocarditis (IE) and AV insufficiency (AVI) are crucial. The aim of this study was to evaluate the outcome of patients with AV IE or AVI treated with the EDWARDS INTUITY Rapid-Deployment AV prosthesis for this off-label indication.

METHODS

This single-centre retrospective study analyzed data from patients who underwent AV replacement with the EDWARDS INTUITY Rapid-Deployment AV prosthesis for AV IE or regurgitation. (n = 8 for IE and n = 6 for AVI).

RESULTS

Heart-lung machine times were significantly shorter in the AVI group (111.3 ± 20.7 min) compared to the IE group (171.9 ± 52.4 min) (p = 0.02). Aortic cross-clamp followed a similar trend (73.7 ± 9.9 min for AVI vs. 113.4 ± 35.6 min for IE) (p = 0.02). The length of ICU stay was also shorter in the AVI group (3.8 ± 2.6 days) compared to the IE group (16.9 ± 8.9 days) (p = 0.005). Postoperative echocardiography revealed no paravalvular leakage or significant valvular dysfunction in any patient. One patient died postoperatively from aspiration pneumonia.

CONCLUSION

The INTUITY valve demonstrates as a safe option for complex AV IE and AVI surgery. Further prospective studies with larger patient cohorts are necessary to confirm these findings and explore the long-term benefits of this approach.

摘要

背景

新型人工瓣膜和手术方法对于缩短手术时间以及改善主动脉瓣(AV)感染性心内膜炎(IE)和主动脉瓣关闭不全(AVI)患者的治疗效果至关重要。本研究的目的是评估使用爱德华兹INTUITY快速部署主动脉瓣假体治疗这种非标签适应症的AV IE或AVI患者的治疗效果。

方法

这项单中心回顾性研究分析了接受爱德华兹INTUITY快速部署主动脉瓣假体置换术治疗AV IE或反流患者的数据。(IE患者8例,AVI患者6例)。

结果

与IE组(171.9±52.4分钟)相比,AVI组的体外循环时间显著缩短(111.3±20.7分钟)(p = 0.02)。主动脉阻断时间也呈现类似趋势(AVI组为73.7±9.9分钟,IE组为113.4±35.6分钟)(p = 0.02)。AVI组的重症监护病房住院时间也比IE组短(3.8±2.6天 vs. 16.9±8.9天)(p = 0.005)。术后超声心动图显示,所有患者均无瓣周漏或明显的瓣膜功能障碍。1例患者术后死于吸入性肺炎。

结论

INTUITY瓣膜被证明是复杂AV IE和AVI手术的安全选择。需要进一步进行更大患者队列的前瞻性研究来证实这些发现,并探索这种方法的长期益处。

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