Aortic Valve Periprosthetic Leakage: Anatomic Observations and Surgical Results

Cicco, Giuseppe De; Lorusso, Roberto; Colli, Andrea; Nicolini, Francesco; Fragnito, C; Capitello, Teresa Grimaldi; Borrello, Bruno; Budillon, Alessandro Maria; Gherli, Tiziano; Beghi, Cesare

doi:10.1016/j.athoracsur.2004.11.058

Cited by 51 publications

(33 citation statements)

References 18 publications

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“…The linearized rate of paravalvular leakage was 0.15% per patient-years, which was much lower than that reported by others researchers [18,19]. We believe strongly that interrupted horizontal mattress sutures with felt pledgets are a sine qua non in its prevention, which, as many other authors also emphasized [16,20], provides better valve stability and may eliminate this adverse complication.…”

Section: Discussioncontrasting

confidence: 43%

Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases

Han

Zhao

Zhang

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Background: Triple valve surgery (TVS) is still of choice for advanced rheumatic heart disease (RHD), which has been associated with reported poor early and late outcomes. We describe the short-and long-term results after TVS in last two decades in Mainland China. Methods: From January 1985 to January 2005, a total of 871 patients (217 men, 654 women), with mean age of 42 AE 11 years, underwent primary TVS for isolated advanced RHD. All patients received replacement procedures in mitral and aortic position (845 mechanical, 26 bioprosthetic), and 840 patients received repair procedures and the other 31 received replacement procedures in tricuspid position (9 mechanical, 22 bioprosthetic). Preoperative, perioperative, and postoperative data were retrospectively analyzed and risk factors affecting early and late survival were evaluated. Results: The 30-day hospital mortality was 8% (n = 71). Presence of ascites, New York Heart Association (NYHA) class IV and lower left ventricular ejection fraction (LVEF) were identified as independent risk factors for hospital mortality. Overall long-term survival rate was 71% AE 3% at 5 years, and 59% AE 5% at 10 years. The cardiac survival rate was 75% AE 3% at 5 years and 63% AE 4% at 10 years. The event-free survival rate at 5 years and 10 years was 61% AE 6% and 41% AE 13%, respectively. Multivariate analysis revealed advanced age, NYHA class IV and lower LVEF were associated with increased late mortality. The freedom from thromboembolism and anticoagulation-related hemorrhage at 10 years was 90% AE 4% and 81% AE 5%, respectively. Of the 508 patients still alive, 376 (74%) were in NYHA class I and II. Conclusions: Primary TVS for advanced RHD appears to offer satisfactory short-and long-term results with excellent symptomatic improvement. Cardiac-related late mortality following TVS may be improved by early surgical treatment before NYHA class IV or deterioration of LVEF occurs. #

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Section: Discussioncontrasting

confidence: 43%

Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases

Han

Zhao

Zhang

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…Anatomic location of the leaks is based on our own adaptation of the accepted surgical nomenclature using the clock-face reference ( Fig. 1) (12,13). Technical success is defined as a successful deployment of an occlusive device across the paravalvular leak without any mechanical interference with the valve prosthesis, or acute conversion to surgery.…”

Section: Methodsmentioning

confidence: 99%

“…The location of the defects was determined by our own modification ( Fig. 1) of the clock-face system in the "surgical view," as previously described (12,13). Electrocardiography-gated computed tomographic angiography (CTA) with 3-dimensional (3D) and 4-dimensional (4D) reconstruction using volume-rendering techniques (TeraRecon, San Mateo, California) was also performed in all but 1 patient to plan the best approach depending on the position of the defect.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcomes in Patients Undergoing Percutaneous Closure of Periprosthetic Paravalvular Leaks

Ruiz

Jelnin

Kronzon

et al. 2011

Journal of the American College of Cardiology

295

235

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“…cause incomplete sealing of the prosthetic valve after surgery [11]. The known risk factors for prosthetic valve dehiscence include bacterial endocarditis, aneurysm of the ascending aorta, and diffuse calcification of the native aortic valve.…”

Section: Cviamentioning

confidence: 99%

Postoperative Complications after Surgical Aortic Valve Replacement

Koo

Lee

Anh

et al. 2017

Cardiovasc Imaging Asia

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Aortic valve replacement is one of the most common major cardiac surgeries worldwide. Despite improvements in surgical techniques, postoperative complications after aortic valve surgery remain a source of substantial morbidity and mortality. Although transthoracic echocardiography and transesophageal echocardiography have been used for routine surveillance of prosthetic heart valves, computed tomography (CT) has played an important role with echocardiography in the diagnosis, treatment, and follow-up of patients after valve replacement. CT has the advantage of evaluating the extent of disease, such as paravalvular dehiscence, abscess, and pseudoaneurysm, in aortic prosthetic valves. In this article, we review the various image findings of postoperative complications after aortic valve replacement detected on CT.

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Aortic Valve Periprosthetic Leakage: Anatomic Observations and Surgical Results

Cited by 51 publications

References 18 publications

Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases

Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases

Clinical Outcomes in Patients Undergoing Percutaneous Closure of Periprosthetic Paravalvular Leaks

Postoperative Complications after Surgical Aortic Valve Replacement

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