Early Clinical Experience with Sutureless Aortic Valve Replacement for Severe Aortic Stenosis
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±èµµÁ¤(Kim Do-Jung) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
±èÈ¿Çö(Kim Hyo-Hyun) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
À̽ſµ(Lee Shin-Young) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
ÀÌ»è(Lee Sak) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
À庴ö(Chang Byung-Chul) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
Abstract
Background: Sutureless aortic valve replacement (SU-AVR) has been developed as an alternative surgical treatment for patients with symptomatic severe aortic stenosis (AS). The aim of this study was to evaluate the clinical outcomes of SU-AVR through an assessment of hemodynamic performance and safety.
Methods: From December 2014 to June 2016, a total of 12 consecutive patients with severe AS underwent SU-AVR. The endpoints were overall survival and valve-related complications (paravalvular leakage, valve thrombosis, migration, endocarditis, and permanent pacemaker implantation). The mean follow-up duration was 18.1¡¾8.6 months.
Results: The mean age of the patients was 77.1¡¾5.8 years and their mean Society of Thoracic Surgeons score was 9.2¡¾17.7. The mean cardiopulmonary bypass and aortic cross-clamp times were 94.5¡¾37.3 minutes and 54.9¡¾12.5 minutes, respectively. Follow-up echocardiography showed good prosthesis function with low transvalvular pressure gradients (mean, 13.9¡¾8.6 mm Hg and peak, 27.2¡¾15.0 mm Hg) at a mean of 9.9¡¾4.2 months. No cases of primary paravalvular leakage, valve thrombosis, migration, or endocarditis were reported. A new permanent pacemaker was implanted in 1 patient (8.3%). The 1-year overall survival rate was 83.3%¡¾10.8%.
Conclusion: Our initial experience with SU-AVR demonstrated excellent early clinical outcomes with good hemodynamic results. However, there was a high incidence of permanent pacemaker implantation compared to the rate for conventional AVR, which is a problem that should be solved.
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Aortic valve stenosis, Bioprosthesis, Heart valve prosthesis implantation
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SU-AVR demonstrated excellent early clinical outcomes with good hemodynamic results. However, there was a high incidence of permanent pacemaker implantation compared to the rate for conventional AVR, which is a problem that should be solved.