Early results of extra-aortic annuloplasty ring implantation on aortic annular dimensions
| Autor: | Raymond Cartier, Ismail El Hamamsy, Louis-Mathieu Stevens, Arsène Basmadjian, Nancy Poirier, Lauren Basmadjian, François-Pierre Mongeon |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male Reoperation medicine.medical_specialty Time Factors medicine.medical_treatment Aortic Valve Insufficiency Diastole Regurgitation (circulation) 030204 cardiovascular system & hematology Doppler echocardiography Prosthesis Design Risk Assessment Severity of Illness Index Cardiac Valve Annuloplasty Cohort Studies 03 medical and health sciences 0302 clinical medicine Postoperative Complications Internal medicine medicine Humans Cardiac skeleton Retrospective Studies Heart Valve Prosthesis Implantation medicine.diagnostic_test business.industry Polyethylene Terephthalates Ross procedure Aortic Valve Stenosis Middle Aged medicine.disease Echocardiography Doppler Surgery medicine.anatomical_structure Treatment Outcome 030228 respiratory system Aortic valve stenosis Heart Valve Prosthesis cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 151(5) |
| ISSN: | 1097-685X |
| Popis: | Dilatation of the aortic annulus is a cause of recurrent aortic regurgitation following the Ross or Yacoub procedures. Use of an extra-aortic annuloplasty ring is a potentially useful adjunct procedure. The aim of this study was to analyze the early effectiveness and mid-term stability of this surgical approach.From 2011 to 2015, 50 patients (mean age, 43 ± 14 years) underwent adjunct extra-aortic annuloplasty ring implantation (n = 39 Dacron rings and n = 11 ExAo rings [CORONEO Inc, Montreal, Canada]). Median ring size was 28 mm (range, 27-32 mm). All patients had aortic regurgitation or a dilated aortic annulus. Concomitant surgical procedure was a valve-sparing remodeling procedure (n = 32) or a Ross procedure (n = 18). Baseline and follow-up echocardiographic systolic and diastolic aortic annular dimensions were prospectively collected. Longitudinal analyses were performed using mixed-effect models. Median follow-up was 12 months (98% complete).Use of an extra-aortic annuloplasty ring resulted in a significant decrease in both systolic (27.9 ± 0.5 mm preoperatively vs 23.6 ± 0.3 mm at discharge, P.001) and diastolic (24.8 ± 0.4 mm preoperatively vs 20.3 ± 0.3 mm at discharge, P.001) dimensions. Mean systolic and diastolic dimensions remained statistically unchanged up to 2 years postoperatively, compared with their predischarge values. Systolic expansion of the annulus was conserved early after surgery (16% systolic expansion) and preserved up to 2 years after ring implantation.Use of an extra-aortic annuloplasty ring is effective at reducing annular diameters. This remains stable at mid-term follow-up, with preservation of aortic annular dynamics. Longer-term studies are required to determine the continued stability and impact on long-term clinical outcomes. |
| Databáze: | OpenAIRE |
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