Sutureless aortic valve replacement with concomitant valvular surgery
| Autor: | Mustafa Serkan Durdu, Mustafa Inan, Çağdaş Baran, Mehmet Cakici, Ahmet Rüçhan Akar, Fatih Gümüş, Mustafa Şirlak |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Heart Valve Diseases 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Mitral valve medicine Humans cardiovascular diseases Aged Retrospective Studies Aged 80 and over Heart Valve Prosthesis Implantation Mitral valve repair Mitral regurgitation Tricuspid valve business.industry Mitral valve replacement Cryoablation Atrial fibrillation Middle Aged medicine.disease Surgery medicine.anatomical_structure 030228 respiratory system Aortic Valve Heart Valve Prosthesis cardiovascular system Mitral Valve Female Tricuspid Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 155:2414-2422 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2017.12.154 |
| Popis: | Objectives Sutureless aortic valve replacement (SU-AVR) is an alternative technique to standard aortic valve replacement. We evaluated our experience with the Perceval SU-AVR with concomitant mitral valve surgery, with or without tricuspid valve surgery, and aimed to discuss the technical considerations. Methods From January 2013 through June 2016, 30 patients with concomitant severe mitral valve disease, with or without tricuspid valve disease, underwent SU-AVR with the Perceval prosthesis in a single center. Results The mean age was 73.0 ± 6.6 years, ranging from 63 to 86 years, and 60% (n = 18) were male. Mean logistic EuroScore of the study cohort was 9.8 ± 4.6. Concomitant procedures consisted of mitral valve repair (n = 8, 26.6%), mitral valve replacement (n = 22, 73.3%), tricuspid valve repair (n = 18, 60%), tricuspid valve replacement (n = 2, 6.6%), and cryoablation for atrial fibrillation (n = 21, 70%). Median prosthesis size was 25 mm (large size). At 1 year, there were 2 deaths from noncardiac causes. One patient (3.3%) had third-degree atrioventricular block requiring permanent pacemaker implantation. Three patients (10%) had intraoperative supra-annular malpositioning of the aortic prosthesis, which was safely removed and reimplanted in all cases. Mean follow-up was 18 ± 4.5 for months (maximum 3 years). During the postoperative period, sinus rhythm restoration rate in patients who underwent the cryo-maze procedure was 76.1% (n = 16) at discharge. There was no structural valve deterioration or migration of the prosthesis at follow-up. Conclusions Perceval SU-AVR is a technically feasible and safe procedure in patients with severe aortic stenosis with good results even in the presence of multivalvular disease and atrial fibrillation surgery. |
| Databáze: | OpenAIRE |
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