EVALUATION OF THE RESULT OF SUTURELESS AORTIC VALVE REPLACEMENT

2019 ◽  
pp. 44-50
Author(s):  
Duc An Vinh Bui ◽  
Hoang Nam Nguyen ◽  
Ba Phong Nguyen ◽  
Adama Sawadogo ◽  
Kasra Azarnoush
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
University Hospital ◽  
Western World ◽  
Replacement Technique ◽  
Risk Patients ◽  
Valve Pathology

Background: Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. In the last few years, sutureless valves have been strongly developed with a lot of applications. The aim of this study was to evaluate the feasibility, mid-term outcomes of sutureless aortic valve replacement technique. Subjects and methods: 13 patients who underwent sutureless aortic valve replacement between 12/2015 to 05/2018 at Clermont – Ferrand University Hospital, France. Descriptive study, postoperative follow-up, clinical evaluation, and echocardiography. Results: mean cross-clamp time was 84.8 ± 22.9 min, mean cardiopulmonary bypass time was 113.4 ± 21.2 min. Improved mean preoperative and postoperative aortic gradients: 40.3 ± 17.4 mmHg versus 10.5 ± 4.8 mmHg (1 month) and 12.0 ± 4.5 mmHg (6 months). Mean intensive care unit stay was 7.8 ± 11.8 days, mean hospital stay was 23.2 ± 15.5 days. No case of death was reported after 6 months. Conclusion: sutureless aortic valve replacement technique is feasible, with good short-term and mid-term outcomes, improve hemodynamics, can be applied in intermediate and high-risk patients. Key words: aortic valve stenosis, aortic valve replacement, sutureless aortic valve

Midterm Outcomes Following Sutureless and Transcatheter Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis

2021 ◽  
Author(s):  
Victoria Vilalta ◽  
Alberto Alperi ◽  
Germán Cediel ◽  
Siamak Mohammadi ◽  
Eduard Fernández-Nofrerias ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Hazard Ratio ◽  
Low Risk ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Baseline Characteristics

Background: Sutureless-surgical aortic valve replacement (SU-SAVR) has been proposed as a surgical alternative for treating aortic stenosis, which facilitates a minimally invasive approach. While some studies have compared the early outcomes of SU-SAVR versus transcatheter aortic valve replacement (TAVR), most data were obtained in high-risk patients and/or limited to in-hospital outcomes. This study aimed to compare in-hospital and midterm clinical outcomes following SU-SAVR and TAVR in low-risk patients with aortic stenosis. Methods: A total of 806 consecutive low-risk (EuroSCORE II <4%) patients underwent TAVR or SU-SAVR between 2011 and 2020 in 2 centers. A 1:1 propensity score matching was performed and identified 171 pairs with similar characteristics that were included in the analysis. Baseline characteristics, in-hospital and follow-up events (defined according to Valve Academic Research Consortium-2) were collected. Results: Baseline characteristics were well balanced between groups, with a median EuroSCORE II of 1.9% (1.3%–2.5%) in both SU-SAVR and TAVR groups ( P =0.85). There were no statistically significant differences regarding in-hospital mortality (SU-SAVR: 4.1%, TAVR: 1.8%, P =0.199) and stroke (SU-SAVR: 2.3%, TAVR: 2.9%, P =0.736), but SU-SAVR recipients exhibited higher rates of bleeding and new-onset atrial fibrillation, higher residual transvalvular gradients ( P <0.001), and a lower rate of pacemaker implantation ( P =0.011). After a median follow-up of 2 (1–3) years, there were no differences between groups in all-cause mortality (hazard ratio, 0.97 [95% CI, 0.52–1.82], P =0.936) and stroke (hazard ratio, 0.83 [95% CI, 0.32–2.15], P =0.708), but SU-SAVR was associated with a higher risk of heart failure hospitalization (hazard ratio, 5.38 [95% CI, 1.88–15.38], P =0.002). Conclusions: In low-risk patients with aortic stenosis, TAVR was associated with improved in-hospital outcomes (except for conduction disturbances) and valve hemodynamics, compared with SU-SAVR. Although similar mortality and stroke rates were observed at 2-year follow-up, the risk of heart failure hospitalization was higher among SU-SAVR patients. These results may contribute to reinforce TAVR over SU-SAVR for the majority of such patients.

Maximal Workload and Oxygen Uptake during Exercise after Aortic-Valve Replacement

2002 ◽  
Vol 11 (1) ◽  
pp. 35-39
Author(s):  
Andreas Schuchert ◽  
Thomas Meinertz
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Outcome Measures ◽  
Exercise Test ◽  
Ventilatory Threshold ◽  
Upright Position ◽  
University Hospital ◽  
Peak Exercise

Context:It is more feasible to assess functional capacity with an exercise test than to measure peak-exercise VO2.Objective:To assess whether maximal workload reliably predicts peak VO2.Patients:Thirty-six patients after aortic-valve replacement during routine follow-up.Design:Incremental symptom-limited cycle exercise test in the upright position with increments of 20 W/min.Setting:Out-clinic patients, university hospital.Main Outcome Measures:Maximal workload, ventilatory threshold, and peak VO2.Results:Maximal workload was 151 ± 39 W, and peak VO2, 1649 ± 486 ml/min. The correlation coefficient between maximal workload and peak VO2wasr= .92 (P< .0001). The regression equation for the estimation of peak VO2wasy= 11.7 (maximal workload in watts) – 110.7. Peak VO2calculated with this equation was 1657 ± 451 ml/min.Conclusions:Maximal workload during ergometry in the upright position reliably predicted peak VO2.

scholarly journals Long-Term Outcomes of Surgical Aortic Valve Replacement in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 10 (11) ◽  
pp. 2492
Author(s):  
Markus Malmberg ◽  
Antti Palomäki ◽  
Jussi O. T. Sipilä ◽  
Päivi Rautava ◽  
Jarmo Gunn ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Cardiovascular Mortality ◽  
Surgical Aortic Valve Replacement

Patients with rheumatoid arthritis (RA) have increased risk of developing cardiovascular disease and events. Little is, however, known about the influence of RA to the outcomes after surgical aortic valve replacement (SAVR). Methods: In a retrospective, nationwide, multicenter cohort study, RA patients (n = 109) were compared to patients without RA (n = 1090) treated with isolated SAVR for aortic valve stenosis. Propensity score-matching adjustment for baseline features was used to study the outcome differences in a median follow-up of 5.6 years. Results: Patients with RA had higher all-cause mortality (HR 1.76; CI 1.21–2.57; p = 0.003), higher incidence of major adverse cardiovascular events (HR 1.63; CI 1.06–2.49; p = 0.025), and they needed more often coronary artery revascularization for coronary artery disease (HR 3.96; CI 1.21–12.90; p = 0.027) in long-term follow-up after SAVR. As well, cardiovascular mortality rate was higher in patients with RA (35.7% vs. 23.4%, p = 0.023). There was no difference in 30-day mortality (2.8% vs. 1.8%, p = 0.518) or in the need for aortic valve reoperations (3.7% vs. 4.0%, p = 0.532). Conclusions: Patients with rheumatoid arthritis had impaired long-term results and increased cardiovascular mortality after SAVR for aortic valve stenosis. Special attention is needed to improve outcomes of aortic valve stenosis patients with RA after SAVR.

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