Early Clinical Experience with Sutureless Aortic Valve Replacement for Severe Aortic Stenosis
10.5090/kjtcs.2018.51.1.1
- Author:
Do Jung KIM
1
;
Hyo Hyun KIM
;
Shin Young LEE
;
Sak LEE
;
Byung Chul CHANG
Author Information
1. Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Aortic valve stenosis;
Bioprosthesis;
Heart valve prosthesis implantation
- MeSH:
Aortic Valve Stenosis;
Aortic Valve;
Bioprosthesis;
Cardiopulmonary Bypass;
Echocardiography;
Endocarditis;
Follow-Up Studies;
Heart Valve Prosthesis Implantation;
Hemodynamics;
Humans;
Incidence;
Prostheses and Implants;
Surgeons;
Survival Rate;
Thrombosis
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2018;51(1):1-7
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Sutureless aortic valve replacement (SU-AVR) has been developed as an alternative surgical treatment for patients with symptomatic severe aortic stenosis (AS). The aim of this study was to evaluate the clinical outcomes of SU-AVR through an assessment of hemodynamic performance and safety. METHODS: From December 2014 to June 2016, a total of 12 consecutive patients with severe AS underwent SU-AVR. The endpoints were overall survival and valve-related complications (paravalvular leakage, valve thrombosis, migration, endocarditis, and permanent pacemaker implantation). The mean follow-up duration was 18.1±8.6 months. RESULTS: The mean age of the patients was 77.1±5.8 years and their mean Society of Thoracic Surgeons score was 9.2±17.7. The mean cardiopulmonary bypass and aortic cross-clamp times were 94.5±37.3 minutes and 54.9±12.5 minutes, respectively. Follow-up echocardiography showed good prosthesis function with low transvalvular pressure gradients (mean, 13.9±8.6 mm Hg and peak, 27.2±15.0 mm Hg) at a mean of 9.9±4.2 months. No cases of primary paravalvular leakage, valve thrombosis, migration, or endocarditis were reported. A new permanent pacemaker was implanted in 1 patient (8.3%). The 1-year overall survival rate was 83.3%±10.8%. CONCLUSION: Our initial experience with SU-AVR demonstrated excellent early clinical outcomes with good hemodynamic results. However, there was a high incidence of permanent pacemaker implantation compared to the rate for conventional AVR, which is a problem that should be solved.
