Effect of preoperative symptoms on outcomes after valve repair for degenerative aortic insufficiency

Vohra, Hunaid A.; deKerchove, Laurent; Whistance, Robert N.; Glineur, David; Noirhomme, Phillipe; Khoury, Gébrine El

doi:10.1093/ejcts/ezt541

Cited by 7 publications

(4 citation statements)

References 22 publications

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Section: Discussionsupporting

confidence: 55%

“…However, after six months of AV replacement, the mean gradient had reduced. A previous study reported a similar reduction in mean AV gradient to 12.0 ± 11.9 and 16.8 ± 11.1 mmHg after 45 months of AV repair in patients who had preoperative peak aortic gradient of <20 and ≥20 mmHg, respectively [ 27 ]. In patients with rheumatic mitral stenosis, the mean transvalvular gradient was reported to be 7 mmHg in mild-to-moderate mitral stenosis and 14 mmHg in severe mitral stenosis, which was reduced to 4 and 6 mmHg, respectively, post-valvuloplasty [ 28 ].…”

Section: Discussionmentioning

confidence: 64%

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Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial

Desai¹,

Bhat²,

M³

et al. 2023

Cureus

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BackgroundParavalvular leak (PVL) following valve replacement is a serious cardiovascular complication that increases morbidity and mortality. Valve replacement with the interrupted suture technique using polyester suture provides adequate tensile strength and reduces the probability of tissue reaction. This study compared the clinical equivalence of Trubond® (Healthium) and Ethibond® (Ethicon, Johnson & Johnson) braided polyester sutures for valvular prosthesis fixation using interrupted suturing, with respect to the proportion of subjects having PVL after aortic valve (AV) or mitral valve (MV) replacement. MethodologyPatients undergoing AV/MV replacement were enrolled and randomized in this study. The primary endpoint of this prospective, multicentric, two-arm, randomized (1:1), parallel-group, single-blind study (December 2020-October 2022) was the presence of PVL in Trubond® (n = 40) and Ethibond® (n = 42) groups within 26 weeks of surgery. The secondary endpoints included event rate of all-cause mortality, cardiac death, stroke, myocardial infarction, re-hospitalization, re-intervention, wound infection, operative time, intraoperative suture parameters, postoperative hospital stay, time to resume normal activities and work, quality of life, patient satisfaction, and adverse events in both groups. ResultsPatients who underwent AV/MV replacement and were followed up until 26 weeks had no incidence of PVL or other postoperative complications. No requirement for readmission or re-intervention was noted in both groups. Intraoperative suture handling characteristics, operative time, and hospital stay were also comparable between the groups. With each follow-up, subjects in both groups exhibited improved postoperative functional abilities, quality of life, and health status. ConclusionsTrubond® braided polyester suture is clinically equivalent to Ethibond® braided polyester suture. Trubond® suture is safe and effective for valvular prosthesis fixation in patients undergoing AV or MV replacement.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 64%

Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial

Desai¹,

Bhat²,

M³

et al. 2023

Cureus

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show abstract

“…The risks of aortic valve reoperation were 10% at 5 years and 21% at 10 years. Vohra and colleagues 3 reported similar outcomes in their series of 274 aortic valve repairs in the course of 14 years for severe aortic insufficiency. Their operative mortality was 0%, and there was a trend toward improved 10-year survival among the patients who underwent surgery without symptoms versus those who had symptoms (100% vs 77%; P ¼ .1).…”

mentioning

confidence: 69%

Gospel of the guidelines

Balsam

DeAnda

2015

The Journal of Thoracic and Cardiovascular Surgery

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“…Should this matched cohort serve as a benchmark for judging AV repair procedures? The average age in the total Brussels AV repair cohort is approximately 50 years, 4 which poses the question of whether the expected AV repair benefits should be the same across all age groups.…”

Section: Repair or Replace The Aortic Valve? More Questions No Answementioning

confidence: 99%

Repair or replace the aortic valve? More questions, no answers

Charitos

Takkenberg

2015

The Journal of Thoracic and Cardiovascular Surgery

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Effect of preoperative symptoms on outcomes after valve repair for degenerative aortic insufficiency

Abstract: In asymptomatic patients with severe degenerative AI, AVr is associated with excellent long-term outcomes, while symptoms are associated with reduced long-term survival. In dilated LV, freedom from reoperation is lower. If feasible, early AVr is recommended in experienced centres.

Cited by 7 publications

References 22 publications

Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial

Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial

Gospel of the guidelines

Repair or replace the aortic valve? More questions, no answers

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