Nicolardi Salvatore, De Masi De Luca Gabriele, Mangia Federica, Greco Cosimo Angelo, Zaccaria Salvatore
Department of Cardiac Surgery, "Vito Fazzi" Hospital, Lecce, Italy.
Cardiology Department, "Card. Panico" Hospital, Tricase (Le), Italy.
Case Rep Surg. 2024 Oct 16;2024:9455342. doi: 10.1155/2024/9455342. eCollection 2024.
Aortic valve replacement (AVR) in a patient with a bio-Bentall conduit can be very challenging, especially if there was a previous endocarditis process for significant morbidity and mortality. We report a case of sutureless AVR in an old patient with a bio-Bentall conduit (Carpentier-Edwards Perimount Magna Ease 25 aortic valve and Hemashield 30 aortic conduit), who developed an endocarditis on aortic prosthesis valve. We believe that sutureless AVR is the best option for redo-operation in older patients with a high surgical risk because it allows for easy rapid deployment implantation, avoids anchoring sutures on a fragile aortic anulus, and reduces cardiopulmonary and aortic cross-clamp times. In this setting, it should be considered as a safe and valid alternative not only to traditional prosthesis but also in selected cases to transcatheter valve-in-valve solutions.
对于使用生物带瓣管道的患者进行主动脉瓣置换术（AVR）可能极具挑战性，尤其是在既往存在心内膜炎且有显著发病率和死亡率的情况下。我们报告了一例老年患者，其使用生物带瓣管道（Carpentier-Edwards Perimount Magna Ease 25主动脉瓣和Hemashield 30主动脉管道），发生了人工主动脉瓣膜心内膜炎，接受了无缝合AVR手术。我们认为，无缝合AVR是手术风险高的老年患者再次手术的最佳选择，因为它便于快速简便地植入，避免在脆弱的主动脉瓣环上固定缝线，并减少心肺转流和主动脉阻断时间。在这种情况下，它不仅应被视为传统人工瓣膜的安全有效替代方案，而且在某些选定病例中也是经导管瓣膜中瓣膜解决方案的替代方案。
