Short to mid-term results of Chimney Commando in redo valve replacement: A retrospective cohort study
- VernacularTitle:“衬裙Commando”术用于二次瓣膜置换术近中期疗效的回顾性队列研究
- Author:
Hongyan LIU
1
;
Bihui HE
1
;
Jing JIN
1
;
Laichun SONG
1
;
Jihui FANG
1
;
Xiang ZHOU
1
;
Yan CHEN
1
;
Liang TAO
1
Author Information
1. Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan, 430022, P. R. China
- Publication Type:Journal Article
- Keywords:
Prosthesis-patient mismatch;
double annulus enlargement;
redo surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(06):860-866
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the application of double valve ring enlargement combined with mitral Chimney technique (Chimney Commando) in the secondary valve replacement and to analyze the efficacy in the near and medium term. Methods Patients who underwent the secondary aortic valve and mitral valve (double valve) replacement by Chimney Commando in Wuhan Asia Heart Hospital from 2019 to 2022 were included, and their clinical data were retrospectively collected to analyze the safety and feasibility of this procedure in secondary valve replacement of small aortic root patients. Results A total of 49 patients (44 females and 5 males) were included. The body surface area was 1.64±0.17 m2. The time from the first operation was 13.10±5.90 years. Except for 4 patients whose first operation was valvuloplasty, the remaining 45 patients were all patients after valve replacement, 41 patients of double valves replacement, including 39 patients with mechanical valve and 2 patients with biological valve. The majority of the aortic valves were St.Jude regent 19 mm or St.Jude regent 21 mm, accounting for 30.61% and 34.69%, respectively. The mitral valves were predominantly St.Jude 25 mm mechanical valves, making up 65.31%. All patients underwent Chimney Commando double valve ring enlargement, and the mean time of aortic occlusion was 154.00±45.40 min. The mean size of the aortic valve was 23.90±1.40 mm and that of the mitral valve was 28.20±1.20 mm, and the transvalvular pressure difference across the aortic valve was 20.16±5.76 mm Hg at 6 months postoperatively. There was one death during hospitalization due to multi-organ failure. The follow-up time ranged from 1 to 24 months with a median time of 8 months. Two patients were implanted with permanent pacemakers during the follow-up period and 1 patient died due to massive stroke and malignant arrhythmia. Conclusion Chimney Commando is safe and effective in patients with secondary double valve replacement, and the postoperative prosthetic valves have good hemodynamics, and can achieve good clinical results in the near and medium term.
