The Aortic Annulus Stabilization Technique Prevents Paravalvular Leaks after Rapid Deployment Aortic Valve Implantation.

annulus stabilization technique aortic valve replacement paravalvular leak rapid-deployment aortic valve

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
10 Dec 2021
Historique:
received: 20 11 2021
revised: 03 12 2021
accepted: 08 12 2021
entrez: 24 12 2021
pubmed: 25 12 2021
medline: 25 12 2021
Statut: epublish

Résumé

Surgical aortic valve replacement with rapid deployment bioprosthesis guarantees good hemodynamic results but carries the risk of paravalvular leaks. To address this issue, an annulus stabilization technique has been recently developed. Clinical and hemodynamic parameters from patients treated for aortic valve replacement with the rapid deployment bioprosthesis and a concomitant annulus stabilization technique were prospectively collected and retrospectively analyzed. Echocardiographic data at discharge and at 1-year follow-up were collected and analysed. A total of 57 patients (mean age 74.3 ± 6.1 years) with symptomatic aortic valve stenosis underwent aortic valve replacement with the rapid deployment bioprosthesis and concomitant annulus stabilization technique (mean valve size: 23.8 ± 1.9 mm). Combined procedures accounted for 56.1%. Hospital mortality was 1.8% and a new pacemaker for conduction abnormalities was implanted in 10 patients. The pre-discharge echocardiographic control showed absence of paravalvular leaks of any degree in all patients with mean valve gradient of 9.6 ± 4.0 mmHg. The 1-year echocardiographic control confirmed the good valve hemodynamic (mean gradient of 8.0 ± 2.8 mmHg) and absence of leaks. In this preliminary clinical experience, the annulus stabilization technique prevents postoperative paravalvular leaks after rapid deployment aortic valve implantation, up to 1-year postoperatively. Studies on larger series are of paramount importance to confirm the long-term efficacy of this new surgical technique.

Sections du résumé

BACKGROUND BACKGROUND
Surgical aortic valve replacement with rapid deployment bioprosthesis guarantees good hemodynamic results but carries the risk of paravalvular leaks. To address this issue, an annulus stabilization technique has been recently developed.
METHODS METHODS
Clinical and hemodynamic parameters from patients treated for aortic valve replacement with the rapid deployment bioprosthesis and a concomitant annulus stabilization technique were prospectively collected and retrospectively analyzed. Echocardiographic data at discharge and at 1-year follow-up were collected and analysed.
RESULTS RESULTS
A total of 57 patients (mean age 74.3 ± 6.1 years) with symptomatic aortic valve stenosis underwent aortic valve replacement with the rapid deployment bioprosthesis and concomitant annulus stabilization technique (mean valve size: 23.8 ± 1.9 mm). Combined procedures accounted for 56.1%. Hospital mortality was 1.8% and a new pacemaker for conduction abnormalities was implanted in 10 patients. The pre-discharge echocardiographic control showed absence of paravalvular leaks of any degree in all patients with mean valve gradient of 9.6 ± 4.0 mmHg. The 1-year echocardiographic control confirmed the good valve hemodynamic (mean gradient of 8.0 ± 2.8 mmHg) and absence of leaks.
CONCLUSION CONCLUSIONS
In this preliminary clinical experience, the annulus stabilization technique prevents postoperative paravalvular leaks after rapid deployment aortic valve implantation, up to 1-year postoperatively. Studies on larger series are of paramount importance to confirm the long-term efficacy of this new surgical technique.

Identifiants

pubmed: 34945072
pii: jcm10245776
doi: 10.3390/jcm10245776
pmc: PMC8703849
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Elena Caporali (E)

Department of Cardiology, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.

Roberto Lorusso (R)

Department of Cardiac Surgery, Maastricht University Hospital, 6229 Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht (CARIM), 6229 Maastricht, The Netherlands.

Tiziano Torre (T)

Department of Cardiac Surgery, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.

Francesca Toto (F)

Department of Cardiac Surgery, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.

Alberto Pozzoli (A)

Department of Cardiac Surgery, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.

Giovanni Pedrazzini (G)

Department of Cardiology, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.
Biomedicine Faculty, Italian Switzerland University (USI), 6900 Lugano, Switzerland.

Stefanos Demertzis (S)

Department of Cardiac Surgery, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.
Biomedicine Faculty, Italian Switzerland University (USI), 6900 Lugano, Switzerland.

Enrico Ferrari (E)

Department of Cardiac Surgery, Cardiocentro Ticino Institute, 8900 Lugano, Switzerland.
Biomedicine Faculty, Italian Switzerland University (USI), 6900 Lugano, Switzerland.

Classifications MeSH