Sutureless aortic bioprosthesis

Martínez‐Comendador, José Manuel; Castaño, Mario; Gualis, Javier; Martín, E.; Maiorano, Pasquale; Otero, Javier

doi:10.1093/icvts/ivx051

Cited by 16 publications

(19 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…C-AVR in patients with a small aortic annulus may result in the prosthesis mismatch which is more common in smaller patients, obese and elderly women with multiple comorbidities. 13 This procedure provides a much larger size with certainly better flow through the aortic root as the mean prosthetic size was greater in this group. 4 Intraoperatively, CPB and cross-clamp time were similar.…”

Section: Discussionmentioning

confidence: 76%

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Sawadogo

Bui-Duc

D’Ostrevy

et al. 2021

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

Introduction: Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. In high-risk patients, conventional aortic valve replacement (C-AVR) carries high rates of morbidity and mortality. In the last few years, rapid-deployment valves (RDV) have been developed to reduce the surgical risks. In this work, we aimed to compare the mid-term outcomes of rapid-deployment AVR (RD-AVR) with those of the C-AVR in high-risk patients. Methods: This retrospective case-control study identified 23 high-risk patients who underwent RD-AVR between 12/2015 to 01/2018. The study group was compared with a control group of 46 patients who were retrospectively selected from a database of 687 C-AVR patients from 2016 to 2017 which matched with the study group for age and Euro SCORE II. Results: RD-AVR group presented more cardiovascular risk factors. Euro SCORE II was higher in the RD-AVR group (P=0.06). In the RD-AVR group, we observed significantly higher mean prosthetic size (P<0.001). In-hospital mortality was zero in RD-AVR group versus 2 deaths in C-AVR group. Hospital stay was longer in the RD-AVR group with statistical significance (P=0.03). In the group AVR with associated cardiac procedures, while comparing subgroups RD-AVR versus C-AVR, early mean gradient was lower in the first cited (P=0.02). The overall mean follow-up was 10.9 ± 4.3 months. Conclusion: The RD-AVR technique is reliable and lead to positive outcomes. This procedure provides a much larger size with certainly better flow through the aortic root. It is an alternative to C-AVR in patients recognized to be surgically fragile.

show abstract

Section: Discussionmentioning

confidence: 76%

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Sawadogo

Bui-Duc

D’Ostrevy

et al. 2021

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

show abstract

“…The main drawback is the technical difficulty and prolonged AXC and CPB times. However, the utilization of sutureless valve implants has been shown to circumvent both of these pitfalls (21,22,26,29,30). Although miniAVR is more invasive than TAVR, it retains the advantages inherent to SAVR.…”

Section: Discussionmentioning

confidence: 99%

Review of minimal access versus transcatheter aortic valve replacement for patients with severe aortic stenosis

Hoffmann

Heiner

Nguyen

2017

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (miniAVR) have become alternatives to surgical aortic valve replacement via median sternotomy (SAVR) to treat severe aortic stenosis (AS). Despite increased interest and utilization, few studies have directly compared TAVR and miniAVR. A review of the current literature shows TAVR to be an indispensable tool for inoperable, high-risk, and perhaps intermediate-risk patients with severe AS. However, it is associated with a number of deleterious perioperative outcomes, such as valvular regurgitation and vascular complications. MiniAVR is associated with decreased intensive care unit (ICU) and hospital length of stay, a lower incidence of blood transfusions, decreased ventilation time, and improved cosmetic results. MiniAVR maintains potential advantages over SAVR, including the implantation of a durable prosthesis and low rates of perioperative myocardial infarction and paravalvular leak. It is associated with longer aortic cross clamp and cardiopulmonary bypass (CPB) times; however, the use of sutureless valve implants can circumvent this. Studies comparing TAVR and miniAVR demonstrate decreased postoperative mortality, valvular regurgitation, and incidence of stroke in the miniAVR cohorts. Few studies currently exist comparing TAVR and miniAVR, as it is hard to compare the typically low-risk miniAVR versus high-risk TAVR patient populations. It is clear that both strategies will be cornerstones in the modern AVR era, but the situations in which to apply each strategy have not yet been clearly delineated. This highlights the need for surgeons to adopt these minimally invasive techniques. We believe there is a compelling role for miniAVR in low-and intermediate-risk patients, but due to the paucity of data, neither TAVR nor miniAVR should be discounted before a randomized, risk-stratified trial is performed. More studies are needed to compare TAVR and miniAVR in low-and intermediate-risk patients.

show abstract

“…A few years ago, post-rheumatic valvular defects represented 22% of all acquired cardiac malformations in Europe [1]. In the elderly population, the most common pathology is aortic stenosis, with a prevalence of approximately 3% [2]. Infective endocarditis is much less common dis-ease with an incidence between 1 and 11/100 000 people per year [3].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of clinical application of Perceval sutureless bioprostheses in emergency patients with unexpected intraoperative findings

Bociański

Puslecki²,

Olasińska-WIśniewska³

et al. 2022

Medical Research Journal

View full text Add to dashboard Cite

Introduction: Sutureless aortic prostheses provide an attractive opportunity for high-risk patients with difficult surgical anatomy of the aortic root.Aim of the study: To assess the outcomes of emergent aortic valve replacement (AVR) with Perceval sutureless bioprostheses in a group of high-risk patients in whom their implantation had not been considered before surgery.Material and methods: Since 2018, 53 sutureless aortic bioprostheses have been implanted in our center.In this single-center retrospective study, 7 high-risk (median EuroSCORE II 9.43%) patients (4 women and 3 men; median age 63 [28 to 73] years) were identified to undergo emergent procedures. They were operated on for active endocarditis on the native valves with extensive destruction of the annulus (n = 4), endocarditis on a previously implanted bioprosthesis (n = 1), organizing thrombus of the mechanical valve (n = 1), and diffuse aortitis (n = 1). Implantation feasibility, as well as postprocedural mortality and morbidity, were evaluated. Results:The following sizes of bioprostheses were used: XL (n = 3); L (n = 2); M (n = 1), and S (n = 1).The median (minimum; maximum) cross-clamping aortic time was 64 (37; 73) minutes while cardiopulmonary bypass time was 86 (49; 188) minutes, respectively. All patients survived operations and the first 30 days. Two of them died in the hospital because of multiorgan failure on 35 th and 45 th postoperative days. The follow-up period ranging from 6 to 40 months was completed by all who were discharged alive.Conclusions: Despite the well-known advantages of sutureless valves, they can be also used successfully in patients in whom standard prosthesis implantation is either impossible or highly demanding, including emergency cases with unexpected intraoperative findings.

show abstract

Sutureless aortic bioprosthesis

Cited by 16 publications

References 31 publications

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Review of minimal access versus transcatheter aortic valve replacement for patients with severe aortic stenosis

Feasibility of clinical application of Perceval sutureless bioprostheses in emergency patients with unexpected intraoperative findings

Contact Info

Product

Resources

About