Early Clinical Experience with Sutureless Aortic Valve Replacement for Severe Aortic Stenosis

대한흉부외과학회지 2018년 51권 1호 p.1 ~ p.7

김도정(Kim Do-Jung) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
김효현(Kim Hyo-Hyun) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
이신영(Lee Shin-Young) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
이삭(Lee Sak) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Cardiovascular Surgery
장병철(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±8.6 months.

Results: The mean age of the patients was 77.1±5.8 years and their mean Society of Thoracic Surgeons score was 9.2±17.7. The mean cardiopulmonary bypass and aortic cross-clamp times were 94.5±37.3 minutes and 54.9±12.5 minutes, respectively. Follow-up echocardiography showed good prosthesis function with low transvalvular pressure gradients (mean, 13.9±8.6 mm Hg and peak, 27.2±15.0 mm Hg) at a mean of 9.9±4.2 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%±10.8%.

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.

키워드

Aortic valve stenosis, Bioprosthesis, Heart valve prosthesis implantation
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
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.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드