Stentless Bioprosthess for Aortic Valve Replacement in Calcific Aortic Stenosis

Kırali, Kaan

doi:10.5772/55373

Cited by 3 publications

(1 citation statement)

References 85 publications

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“…Aortic valve stenosis with moderate signs (mean gradient > 30 mmHg; aortic valve area 1-1.5 cm 2 ), pathologic bicuspid aortic valve, or severe annulovalvular calcification can indicate for associated aortic valve replacement. Stentless biological valves must be the first choice if the aorticoventricular continuity is not disturbed [47].…”

Section: Valvular Pathologiesmentioning

confidence: 99%

Coronary Artery Bypass Surgery

Kırali¹,

Saçlı²

2015

Coronary Artery Disease - Assessment, Surgery, Prevention

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Surgical treatment of coronary artery disease should increase regional coronary flow reserve and not increase any early or late morbidity and mortality more than the other treatment modalities. In the past years, surgical treatment of coronary artery disease has been adapted rapidly worldwide and several techniques have been developed to decrease total surgical risks and to improve early and late results with the highest level of quality of life. In spite of the last guidelines that offer stents for single or multiple vessels disease, the fact is that surgical revascularization has better outcomes in all groups of coronary artery patients. In the past two decades, the main target has been to limit or eliminate side effects of extracorporeal circulation and cardioplegia off-pump , and general anesthesia awake coronary bypass . The prime goal of surgical revascularization is to obtain complete revascularization by bypassing all severe stenotic coronary arteries having a diameter larger than mm. Surgical revascularization with cardiopulmonary bypass through a full sternotomy remains the most widely used surgical technique. With the development of stabilization devices, off-pump procedures can be safely performed in most patients with single or multivessel disease. Minimal invasive and/or robotic surgery is an attractive procedure to catch invasive cardiology. The gold standard strategy involves single graft to single target vessel bypass, especially the left internal mammary artery to the left anterior descending artery. The early cumulative mortality rate is below %, but lower than % in lower-risk patients. There are some variables most predictive of early mortality older age, female, reoperation, non-elective surgery, left ventricular dysfunction, accelerated atherosclerosis. The survival rate is higher than % for years. Late mortality is dependent not only on non-use of internal mammarian artery, closure of grafts, progression of native arterial disease but also on comorbidities. Satisfactory quality of life after surgery depends on the long-term duration of the freedom from angina, heart failure, rehospitalization and reintervention, and improvement of the exercise capacity. Return of angina during the first months depends on incomplete revascularization or graft failure, whereas progression of native-vessel disease and grafts are serious risk factors for the late recurrence of angina. Venous graft occlusion is the most common reason for reintervention, and native vessel disease is the second.

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Section: Valvular Pathologiesmentioning

confidence: 99%

Coronary Artery Bypass Surgery

Kırali¹,

Saçlı²

2015

Coronary Artery Disease - Assessment, Surgery, Prevention

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Conventional Aortic Valve Surgery (Open Surgical Approaches)

Kırali

Yerlikhan

2018

New Approaches to Aortic Diseases From Valve to Abdominal Bifurcation

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Propensity score matching analysis of the aortiv valve replacement with the xenopericardial semi-framed prosthesis “T-Ara” and the framed xenopericardial prosthesis “UniLine”. Short-term results

Евтушенко

Stasev

Кокорин

et al. 2023

Kompleks. probl. serdečno-sosud. zabol.

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Highlights. It is the first pseudorandomized comparative study of xenopericardial frame and half-frame bioprostheses treated with diepoxin in the aortic position use and its direct results.Aim. A comparative assessment using the Propensity Score Matching method of the in-hospital clinical and hemodynamic results of the semi-framed epoxy-treated xenopericardial prosthesis “T-ara” and the framed epoxy-treated xenopericardial prosthesis “UniLine” (“NeoKor”, Kemerovo, Russia) for isolated aortic valve replacement implantation.Methods. 33 recipients of the “UniLine” prosthesis were selected by Propensity Score Matching method in a ratio of 1:1 to 33 observations from the “T-ara” group according to the compliance criteria: gender, age, body surface area, end-diastolic volume of the left ventricle (LV) and the pre-operative presence/absence of the aortic regurgitation.Results. Hospital mortality in the “T-ara” and “UniLine” groups was 3.03 (n = 1) and 6.06% (n = 2), respectively, p = 0.920. Non-fatal complications in the “T-ara” and “UniLine” groups was 7 (21.2%) and 18 (54.6%), p = 0.163. The incidence of postoperative heart failure and arrhythmias was higher in “UniLine” recipients (p = 0.001). The average stay in the intensive care unit was longer in the “UniLine” group than in the “T-ara” group, p = 0.05. Postoperative end-systolic and end-diastolic dimensions and volumes (and the corresponding indexes) of the LV, as well as the myocardial mass and its index in both groups had no statistically significant changes in relation to preoperative data. The comparative assessment of left ventricular remodeling parameters depending on the prosthetic size revealed no significant differences. The average pressure gradient in the “T-ara» and “UniLine” group of size 21mm was 12.2±7.4 and 12.2±5.0 mm Hg. (p>0.050). The average pressure gradient in the group “T-ara” and “UniLine” size 23–25 mm was 10.2±4.1 and 9.9±0.3 mm Hg, p>0.050. The regression degree of LV myocardial mass index in the groups did not have significant differences.Conclusion. At the hospital stage, the semi-framed epoxy-treated biological prosthesis “T-ara” has a similar clinical and hemodynamic profile with the framed biological prosthesis “UniLine”. The frequency of postoperative heart failure and cardiac arrhythmias is statistically significantly higher in the “UniLine” group (framed bioprostheses).

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Stentless Bioprosthess for Aortic Valve Replacement in Calcific Aortic Stenosis

Abstract: Figure 1. First generation bioprostheses (Porcine Stentless Xenografts) A) Scalloped stentless porcine bioprostheses B) Root stentless porcine bioprostheses.

Cited by 3 publications

References 85 publications

Coronary Artery Bypass Surgery

Coronary Artery Bypass Surgery

Conventional Aortic Valve Surgery (Open Surgical Approaches)

Propensity score matching analysis of the aortiv valve replacement with the xenopericardial semi-framed prosthesis “T-Ara” and the framed xenopericardial prosthesis “UniLine”. Short-term results

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