Baran Cagdas, Kayan Ahmet, Baran Canan Soykan, Karacuha Ali Fuat, Eryilmaz Sadik
Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06230 Ankara, Turkey.
Department of Cardiovascular Surgery, Kirikkale High Specialization Hospital, 71300 Kirikkale, Turkey.
Medicina (Kaunas). 2024 Dec 11;60(12):2037. doi: 10.3390/medicina60122037.
: This study aims to assess the postoperative outcomes and complications of sutureless and sutured aortic valve replacement in patients with infective endocarditis. : A total of 58 patients who underwent redo aortic valve replacement for bacterial or non-bacterial endocarditis between January 2018 and March 2023 were included in our study. Surgical procedures were performed through a full median sternotomy due to redo cases and to provide optimal access. Demographic characteristics, operative times, postoperative complications and some echocardiographic data were compared. All cases were meticulously evaluated preoperatively by a cardiac team to select the best treatment option. : The mean ICU length of stay was significantly shorter in the sutureless valve group at 5.4 ± 3.9 days compared to 7.9 ± 4.1 days in the sutured valve group ( = 0.029). However, the sutureless group had a mean operation time of 164.7 ± 37.3 min, while the sutured group had a mean operation time of 197.7 ± 45.6 min ( = 0.044). Again, the difference in cardiopulmonary bypass times between the two groups was statistically significant ( = 0.039). And again, four (14.2%) patients in the sutureless group underwent reoperation due to bleeding, while eight (26.6%) patients in the sutured group underwent postoperative bleeding control ( = 0.048). : Our study suggests that sutureless aortic valve replacement may offer advantages in terms of operative efficiency and postoperative recovery compared to conventional sutured valves, with some significant differences in terms of some complications.
本研究旨在评估感染性心内膜炎患者行无缝合与有缝合主动脉瓣置换术的术后结局及并发症。本研究纳入了2018年1月至2023年3月间因细菌性或非细菌性心内膜炎接受再次主动脉瓣置换术的58例患者。由于是再次手术病例且为了提供最佳入路，手术通过全胸骨正中切开术进行。比较了人口统计学特征、手术时间、术后并发症及一些超声心动图数据。所有病例术前均由心脏团队进行细致评估以选择最佳治疗方案。无缝合瓣膜组的平均重症监护病房住院时间显著短于有缝合瓣膜组，分别为5.4±3.9天和7.9±4.1天（P = 0.029）。然而，无缝合组的平均手术时间为164.7±37.3分钟，而有缝合组的平均手术时间为197.7±45.6分钟（P = 0.044）。两组之间的体外循环时间差异也具有统计学意义（P = 0.039）。此外，无缝合组有4例（14.2%）患者因出血接受再次手术，而有缝合组有8例（26.6%）患者接受术后出血控制（P = 0.048）。我们的研究表明，与传统有缝合瓣膜相比，无缝合主动脉瓣置换术在手术效率和术后恢复方面可能具有优势，在一些并发症方面存在显著差异。
