Department of Adult Cardiac Surgery, Heart Institute Ministry of Healthcare of Ukraine, Kyiv, Ukraine.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.24-00067.
Aortic valve neocuspidization (AVNeo) is a relatively recent advancement in surgical AV replacement. Data on its performance beyond the short term are limited. We assessed the mid-term outcomes in patients undergoing AVNeo, focusing on feasibility, perioperative details, and its role in AV pathology treatment.
Sixty-five consecutive patients underwent AVNeo between December 2016 and February 2018. Clinical data were prospectively collected and retrospectively analyzed. Tricuspid reconstruction with autologous pericardium was performed in all cases. Echocardiographic follow-up was conducted post-discharge, at 6 and 12 months, and annually thereafter.
The mean age was 62.6 ± 18.7 years. AVNeo was feasible in all cases. Concomitant procedures were performed in 43 (66.2%) patients. Mean bypass and cross-clamp times were 119.2 ± 30.3 and 87.1 ± 22.9 minutes, respectively. Postoperative transvalvular hemodynamics was excellent. There was one (1.5%) in-hospital death. Follow-up (mean 66.72 ± 12.77 months) was complete in 58 patients (89.2%). There were no detected valve-related or thromboembolic events. Transvalvular hemodynamic parameters were stable during the observation period: peak pressure gradient at discharge and follow-up was 15.3 ± 4.6 mmHg and 15.01 ± 6.3 mmHg, respectively (ρ = 0.346).
AVNeo demonstrated the feasibility and favorable mid-term outcomes. Studies with longer-term observation are warranted to evaluate its durability.
主动脉瓣新生物成形术（AVNeo）是外科主动脉瓣置换术的一项相对较新的进展。关于其短期以外的性能的数据有限。我们评估了接受 AVNeo 的患者的中期结果，重点是可行性、围手术期细节及其在治疗主动脉瓣病变中的作用。
65 例连续患者于 2016 年 12 月至 2018 年 2 月期间接受 AVNeo。前瞻性收集临床数据并进行回顾性分析。所有病例均采用自体心包进行三尖瓣重建。超声心动图随访在出院后、6 个月和 12 个月以及此后每年进行。
平均年龄为 62.6 ± 18.7 岁。所有病例均可行 AVNeo。43 例（66.2%）患者同时进行了其他手术。平均体外循环和主动脉阻断时间分别为 119.2 ± 30.3 分钟和 87.1 ± 22.9 分钟。术后跨瓣血流动力学极佳。有 1 例（1.5%）院内死亡。58 例（89.2%）患者的随访（平均 66.72 ± 12.77 个月）完整。未发现瓣膜相关或血栓栓塞事件。观察期间跨瓣血流动力学参数稳定：出院和随访时的峰值压力梯度分别为 15.3 ± 4.6 mmHg 和 15.01 ± 6.3 mmHg（ρ=0.346）。
AVNeo 显示了可行性和良好的中期结果。需要进行更长时间观察的研究来评估其耐久性。
