Sutureless aortic bioprosthesis replacement in elderly Asian patients with aortic stenosis: Experience in a single institution

Lin, Chun‐Yu; Lee, Hsiu-An; Lin, Pyng-Jing; Wang, Chun-Li; Hung, Kuo‐Chun; Tsai, Feng‐Chun

doi:10.1016/j.bj.2018.04.008

Cited by 4 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The modified implant techniques for type 0 of BAV followed the four principles abbreviated as “ECHO” has been published. 6 In brief, The “E” refers to regain annular “Elasticity.” Complete removal of both diseased cups and supra-annular calcified plaques to restore annular elasticity is cornerstone with the Perceval sutureless valve. This will not only provide a better sizing reference but also better adaptation to the implanted prosthesis.…”

Section: Methodsmentioning

confidence: 99%

“…1 2 However, several expert consensus meetings have advised caution with the application of the Perceval sutureless valve to bicuspid aortic valve (BAV), which is classified by Sievers and based on the number of raphes with further subclassification based on the spatial position of cusps or raphes and the functional status of the valve, 3 and especially for type 0 because of the concern of the elliptical shape of the annulus would not accommodate to the prosthesis exactly and respond with malposition. 4 5 After acquiring experiences from our first 15 patients with degenerative aortic stenosis (AS) treated with Perceval sutureless valves, 6 we modified our implant techniques for patients with BAV. 7 In this study, we reviewed 20 consecutive cases of BAV treated with Perceval sutureless valves, focusing on immediate surgical outcomes, midterm clinical performance, and valve hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sutureless Valve in Bicuspid Aortic Stenosis: Modified Technique and Midterm Outcome

Tsai

et al. 2022

Thorac Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

Background The sutureless valve has gained popularity for degenerative aortic valve stenosis but not congenital bicuspid aortic valve (BAV) due to anatomical challenges. We reviewed our modified implant techniques for patients with BAV. Methods From June 2015 to June 2019, 66 patients with aortic valve stenosis were treated with the Perceval sutureless valve, 20 of whom had BAV. The demographics, type of BAV (the Sievers classification), and associated pathologies, surgical outcomes, and midterm hemodynamics were recorded. Results The median age was 64 (range: 49–81) years and the Society of Thoracic Surgeons score was 2.186 (range: 0.407–6.384). Annular plication was performed in 9 (75%) of 12 type 0 and 3 (37.5%) of 8 type I, with implanted valve sizes of M, L, and XL in 6, 10, 4 cases, respectively. Three patients, all type 0 in the initial learning periods, required intraoperative redeployment due to malposition of the valve. The final implant was successful in all without conversion to traditional prosthesis. The median extubation time was 4 hours and the durations of intensive care unit and hospital stay were 1 and 6 days. At a median follow-up of 46 (23–72) months, there was one late mortality due to hemorrhagic stroke sequel. The last echo revealed none had more than mild paravalvular leakage and the mean transvalvular pressure gradient remained stable at 9.70 (range: 6.94–15.0) mm Hg. Conclusions The sutureless valve can achieve satisfactory outcomes in BAV without paravalvular leakage and excellent hemodynamics. It may serve as the benchmark for transcatheter aortic valve implantation in this unique population.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sutureless Valve in Bicuspid Aortic Stenosis: Modified Technique and Midterm Outcome

Tsai

et al. 2022

Thorac Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…39 Fifty-one percent of patients in SV group had bigger valve size implanted than 19-21 mm as compared to 35% of patients in ARE group in this study. The absence of a standard bioprosthetic valve stent and sutured ring leads to the implantation of a larger-profile SV, 47 which may be advantageous for future ViV TAVI in SV. 48…”

Section: Prosthesis-patient Mismatchmentioning

confidence: 99%

Sutureless valves versus aortic root enlargement for aortic valve replacement in small aortic annulus: A systematic review and pooled analysis

Agarwal

Arnav

Ranjan

et al. 2023

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

Background Very few studies provide direct comparisons between aortic root enlargement and sutureless valve implantation in patients with a small aortic annulus who underwent aortic valve replacement. This study aims to provide comparative outcomes between the two in such a subset of patients, through a systematic review and pool analysis. Methods The PubMed, Scopus and Embase databases were searched using the appropriate terms. The data from original articles mentioning aortic root enlargement and sutureless valves in a single or comparative study with another group of patients with a small aortic annulus were pooled and analyzed using descriptive statistics. Results Both cardiopulmonary bypass (68.4 vs. 125.03 min, p < 0.001) and aortic cross-clamp times were significantly shorter in the sutureless valve group, along with a concomitantly higher number of minimally invasive surgeries. The incidence of permanent pacemaker implantation (9.76% vs. 3.16%, p < 0.00001), patient prosthesis mis-match and paravalvular leak was significantly higher in the sutureless valve group. In comparison, the incidence of re-exploration for bleeding was higher in the aortic root enlargement group (5.27% vs. 3.16%, p < 0.02). The two groups had no differences in the duration of hospital stays or mortality. Conclusions Sutureless valves demonstrated a comparable hemodynamic outcome with aortic root enlargement in patients with a small aortic annulus. In addition to this, it greatly facilitated minimally invasive surgery. However, the high incidence of pacemaker implantation is still a concern for the widespread recommendation of sutureless valves, especially in young patients with a small aortic annulus.

show abstract

“…Here, Lin et al. [27] examine the safety and efficacy of SU-AVR in an elderly Asian patient population. They conclude that SU-AVR is safe for this patient population, leading to excellent valve hemodynamics and an improvement in clinical symptoms, while also offering reduced surgery time and possibility to remove the diseased valve.…”

Section: Also In This Issuementioning

confidence: 99%

The influenza chronicles: From the 1918 pandemic to current understanding of host defense mechanisms

Walton¹

2018

Biomedical Journal

View full text Add to dashboard Cite

In this special edition of the Biomedical Journal, we learn about the battle between host and influenza virus at the respiratory epithelium, and how the history of influenza pandemics has driven both major advances in the understanding of immunology and planning for future outbreaks. We also learn of a nanoparticle system that holds promise for photodynamic therapy in breast cancer. Finally, we add evidence to the debate of the safety of a minimally invasive technique for aortic valve replacement in elderly patients.

show abstract

Sutureless aortic bioprosthesis replacement in elderly Asian patients with aortic stenosis: Experience in a single institution

Cited by 4 publications

References 21 publications

Sutureless Valve in Bicuspid Aortic Stenosis: Modified Technique and Midterm Outcome

Sutureless Valve in Bicuspid Aortic Stenosis: Modified Technique and Midterm Outcome

Sutureless valves versus aortic root enlargement for aortic valve replacement in small aortic annulus: A systematic review and pooled analysis

The influenza chronicles: From the 1918 pandemic to current understanding of host defense mechanisms

Contact Info

Product

Resources

About