Intraoperative Transesophageal and Postoperative Transthoracic Echocardiographic Evaluation of a Mechanical Heart Valve Prosthesis Implanted at Aortic Position

Babu, Saravana; Sreedhar, Rupa; Gadhinglajkar, Shrinivas; Dash, Pramod K.; Sukesan, Subin; Pillai, Vivek; Panicker, Varghese Thomas; Shriram, Lovhale Pravin; Aggarwal, Navneet

doi:10.1053/j.jvca.2017.09.001

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…Hence, with these inconclusive data, we cannot confirm whether the hemodynamic effects of MV repair in our study are consistent with what has been previously reported. TEE evaluation in the post-CPB period has important effects in the outcomes of valve replacement surgeries 9,17 . Even so, there are few reports describing iTEE Doppler characteristics of repaired MVs and prosthetic MVs.…”

Section: Discussionmentioning

confidence: 99%

“…This has led us to evaluate iTEE Doppler features and correlate them with post-TTE data. Post-CBP Doppler derided velocities and gradients depend on several hemodynamic effects, like inotropes, surgical bleeding and blood transfusion 9,18 . Post-CBP changes in loading conditions lead to changes in stroke volumes, which modify Doppler velocities and pressure gradients 9,17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…Post-CBP Doppler derided velocities and gradients depend on several hemodynamic effects, like inotropes, surgical bleeding and blood transfusion 9,18 . Post-CBP changes in loading conditions lead to changes in stroke volumes, which modify Doppler velocities and pressure gradients 9,17,18 . Therefore, the ability of these flow-dependent parameters to accurately and reliably represent repaired valve/prosthetic valve function is questionable.…”

Section: Discussionmentioning

confidence: 99%

“…MV repair is currently facilitated by the accurate assessment of MV anatomy and MR mechanisms through comprehensive TEE 5,6 . Additionally, intraoperative TEE (iTEE) has become a routine monitoring technique for heart-valve surgery evaluation, and has been reported to improve outcomes after the termination of cardiopulmonary bypass (CPB) 7,8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

Alves,

Branco,

Marinho

et al. 2019

Preprint

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OBJECTIVES Intraoperative transesophageal echocardiography (iTEE) has an important role in diagnosing the results of mitral valve (MV) replacement and repair. However, intraoperative Doppler features may be dissimilar from those measured at the postoperative follow-up period due to hemodynamic variations. There are no studies regarding MV surgery and comparisons between iTTE and postoperative transthoracic echocardiography (post-TTE). We aimed to evaluate the Doppler flow profiles observed in iTEE after MV replacement and repair and compare them with those observed in post-TTE. METHODS We conducted an observational study of 76 patients who underwent MV surgery (replacement or repair) over a 10-month period. iTEE was performed with Doppler evaluation (mean pressure gradient [MPG] and functional area). Patients were re-evaluated with TTE 72 hours after surgery (post-TTE). iTEE and post-TTE Doppler values were then compared and correlated. RESULTS The patients' mean age was 59 ± 18 years and 55% were women. The prevalence of severe mitral regurgitation and severe mitral stenosis was 77.6% and 22.4%, respectively. MV repair was performed in 71% of cases. iTEE Doppler parameters correlated with post-TTE parameters, with minimal differences, specially in the MV repair group. The postoperative MPG was +0.4 ± 1 mmHg higher in the MV repair group and +1.0 ± 1.8 mmHg in the MV replacement group. There was global improvement in terms of systolic pulmonary artery pressure, although left ventricular ejection fractions were slightly reduced during the postoperative evaluation. CONCLUSIONS Our study demonstrates the usefulness of iTEE and its importance in establishing possible reference values for postoperative follow-ups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

Alves,

Branco,

Marinho

et al. 2019

Preprint

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“…However, Transesophageal echo is still the gold standard method for immediate post procedure assessment of heart valve repair or replacement [16]. Additionally, Patients with PVL may remain asymptomatic for long period and can be associated with heart failure, hemolysis and/or endocarditis [17]. PVL has been known to be associated with heart valve surgery, despite the use of traditional hand-tie [18,19] Moderate to severe paravalvular leak was reported to be present in the range of 3-6% in studies done by O'Rourke et.…”

Section: Paravalvular Leak (Pvl)mentioning

confidence: 99%

Incidence of valvular regurgitation and leaflet perforation by using automated titanium fasteners (CORKNOT®) in heart valve repair or replacement: less usual than reported

Sazzad

Xian

Ler

et al. 2021

J Cardiothorac Surg

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Background CORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries. Methods Patients who underwent heart valve repair or replacement surgery via the use of automated titanium suture fasteners (CORKNOT®) in a tertiary care hospital were included in the study. This single-centre retrospective study was conducted on 132 patients between January 2016 and June 2018. Results In our study, the overall mean operative time was 320.0 ± 97.0 min, mean CPB time was 171.4 ± 76.0 min and the calculated mean ACC time was 105.9 ± 54.0 min. Fifty-eight patients (43.9%) underwent minimally invasive valve replacement or repair surgery and 66 patients (50.0%) underwent concomitant procedures. A total of 157 valves were operated on, with 112 (84.8%) single valve surgeries, 15 (11.4%) double valve surgeries and 5 (3.8%) triple valve surgeries. After reviewed by the cardiologist blinded towards the study, we report trivial and/or mild paravalvular leak (PVL) in immediate post-operative echocardiography was found in 1 (1.01%) patients. There were no reported cases of valvular thrombosis, leaflet perforation, device dislodgement or embolization, moderate and/or severe PVL during hospitalization and follow-up echocardiography within 1 year. Single mitral valve and aortic surgeries had comparable incidences of post surgical complications. Conclusion We conclude the feasibility of CORKNOT® utilisation in mitral and aortic valve surgeries. Additionally, incidence of CORKNOT® related complications in heart valve repair or replacement surgery is less usual in our setting than previously reported. These results motivate the use of CORKNOT® as a valid alternative with complete commitment.

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Correlations between intraoperative and postoperative echocardiographic measurements in patients undergoing aortic bioprosthetic valve replacement: a prospective observational study

Minami,

Kazawa

2024

Gen Thorac Cardiovasc Surg

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Intraoperative Transesophageal and Postoperative Transthoracic Echocardiographic Evaluation of a Mechanical Heart Valve Prosthesis Implanted at Aortic Position

Cited by 4 publications

References 20 publications

Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

Incidence of valvular regurgitation and leaflet perforation by using automated titanium fasteners (CORKNOT®) in heart valve repair or replacement: less usual than reported

Correlations between intraoperative and postoperative echocardiographic measurements in patients undergoing aortic bioprosthetic valve replacement: a prospective observational study

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