Impact of Suture Techniques for Aortic Valve Replacement on Prosthesis-Patient Mismatch.

Kim, Hyo-Hyun; Lee, Sak; Joo, Hyun-Chel; Kim, Jung-Hwan; Youn, Young-Nam; Yoo, Kyung-Jong; Lee, Seung Hyun
The Annals of thoracic surgery
2019Oct ; 11 ( 10 ) :.
저자 상세정보
Kim, Hyo-Hyun - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea.
Lee, Sak - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
Joo, Hyun-Chel - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
Kim, Jung-Hwan - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
Youn, Young-Nam - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
Yoo, Kyung-Jong - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
Lee, Seung Hyun - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
ABSTRACT
BACKGROUND: Many variables may affect the hemodynamic performance of the aortic valve prosthesis, and suture technique remains an important factor for determining maximum valve performance. The objective of this study was to determine the suture technique that produces better hemodynamic performance for aortic valve replacement (AVR).

METHODS: Patients who underwent AVR between January 2015 and September 2018 in our institution were analyzed. We compared the preoperative clinical information and 1-year postoperative hemodynamic data of interrupted pledget mattress sutures (pledgeted group), interrupted nonpledget mattress sutures (nonpledgeted group), and figure-of-8 nonpledget sutures (figure-of-eight group). We compared the incidence of prosthesis-patient mismatch (PPM) and cardiac adverse events among the groups and subanalyzed the PPM rate in a small aortic annulus (18 to 21 mm).

RESULTS: A total of 439 patients underwent AVR (pledgeted, n?= 212; nonpledgeted, n?= 122; figure-of-eight, n?= 105). The groups were similar in age (P?= .359), sex (P?= .055), underlying disease, and valve pathology. There was no difference in inhospital mortality or cardiac adverse events in each suture group (P?= .282). The nonpledgeted suture had significantly lower moderate (P < .01) and severe PPM rates (P?= .01) in patients with a small aortic annulus (18 to 21 mm).

CONCLUSIONS: The interrupted nonpledget mattress suture offers complete supraannular implantation, which reduces the incidence of PPM and results in?better hemodynamic improvement after small-size?AVR. CI - Copyright ??2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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링크

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)
The interrupted nonpledget mattress suture offers complete supraannular implantation, which reduces the incidence of PPM and results in better hemodynamic improvement after small-size AVR.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
KCD코드
ICD 03
건강보험코드