Kolseth Solveig Moss, Saeed Sahrai, Salminen Pirjo-Riitta, Ellensen Vegard Skalstad, Kvalheim Venny Lise, Ali Abukar Mohamed, Haaverstad Rune
Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, Bergen, 5021, Norway.
Department of Clinical Sciences, The Medical Faculty, University of Bergen, Bergen, Norway.
J Cardiothorac Surg. 2024 Dec 20;19(1):667. doi: 10.1186/s13019-024-03178-9.
There are several high-risk treatment options for valve failure of a biological full root replacement. When tailoring the best treatment option for the patient, implantation of a rapid deployment valve (RDV) should be considered.
Six patients presented with aortic regurgitation in a full root Freestyle bioprosthesis. Three had a history of valve endocarditis, while the remaining had non-infectious structural valve deterioration with leaflet and commissural tears. All patients were treated with a rapid deployment EDWARDS INTUITY Elite valve. Follow-up was complete for all patients. Postoperative echocardiography showed well-functioning valve prostheses with no paravalvular leaks and acceptable pressure gradients. Echocardiographic follow-up demonstrated excellent pressure gradients and a considerable decrease in the left ventricular mass index and left ventricular end-diastolic dimensions. Follow-up cardiac CT showed no signs of coronary obstruction or other pathology. During a median follow-up of 30 months neither biological valve failure, nor any events within the composite endpoint of major adverse cardiac and cerebrovascular events occurred.
This case series presents the EDWARDS INTUITY valve as a good treatment option in patients with failing Freestyle roots.
对于生物全根置换瓣膜功能衰竭，有几种高风险治疗方案。在为患者定制最佳治疗方案时，应考虑植入快速部署瓣膜（RDV）。
6例患者出现Freestyle生物瓣膜全根主动脉瓣反流。其中3例有瓣膜心内膜炎病史，其余患者有非感染性结构性瓣膜退变伴瓣叶和瓣交界撕裂。所有患者均接受了快速部署的爱德华兹INTUITY Elite瓣膜治疗。所有患者均完成随访。术后超声心动图显示瓣膜假体功能良好，无瓣周漏，压力梯度可接受。超声心动图随访显示压力梯度极佳，左心室质量指数和左心室舒张末期内径显著降低。随访心脏CT未显示冠状动脉阻塞或其他病变迹象。在中位随访30个月期间，既未发生生物瓣膜功能衰竭，也未发生主要不良心脑血管事件复合终点内的任何事件。
本病例系列表明，爱德华兹INTUITY瓣膜是Freestyle根部功能衰竭患者的良好治疗选择。
