초록접수 현황
| 17F-142 | 구연 발표 |
Simple Interrupted Suturing for Aortic Valve Replacement in Patient with Severe Aortic Stenosis.
Chee-hoon Lee, Min Ho Ju, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Attaining adequate effective orifice area (EOA) is definitive goal for aortic valve replacement (AVR). A simple interrupted sutures (SIS) technique could be a solution to achieve this goal, but referenced data has been limited. This study aims to compare hemodynamic changes between SIS and non-everting mattress suture (NMS) techniques.
Methods : From the data of our institutional record, 218 patients who underwent AVR (supra-annular) for severe aortic stenosis were formed overall cohort. SIS technique was used in 79 patients, while NMS technique was used in 139 patients from March 2015 to November 2016. Hemodynamic outcomes detected by echocardiography and computed tomography (CT) were evaluated.
Results : The patients with bicuspid aortic valve were 47.5%(n=66) and 58.2%(n=45) in NMS and SIS groups, respectively. Bio-prosthetic valve replacement was performed in 66.9%(n=93) of NMS group and 58.2%(n=46) in SIS group. There were no significant differences in baseline data from CT and echocardiography between two groups. In immediate postoperative echocardiography, SIS group showed significantly wider EOA (1.6±0.4 vs. 1.4±0.5 cm2; P=0.007) and lower mean trans-aortic pressure gradient (13.3±5.4 vs. 17.0±6.0 mmHg; P<0.001) compared with NMS group. In the next echocardiography, SIS group remained wider EOA (1.6±0.4 vs. 1.4±0.3 cm2; P<0.001) and lower mean trans-aortic pressure gradient (11.0±5.1 vs. 14.1±5.5 mmHg; P<0.001) than NMS group. There was no significant difference of paravalvular-leakage. (SIS group vs. NMS group; 1.3% vs. 5%; P=0.29).
Conclusion : SIS technique for AVR was related to wider EOA and low mean pressure gradient. This technique may be a reasonable option for AVR.
Methods : From the data of our institutional record, 218 patients who underwent AVR (supra-annular) for severe aortic stenosis were formed overall cohort. SIS technique was used in 79 patients, while NMS technique was used in 139 patients from March 2015 to November 2016. Hemodynamic outcomes detected by echocardiography and computed tomography (CT) were evaluated.
Results : The patients with bicuspid aortic valve were 47.5%(n=66) and 58.2%(n=45) in NMS and SIS groups, respectively. Bio-prosthetic valve replacement was performed in 66.9%(n=93) of NMS group and 58.2%(n=46) in SIS group. There were no significant differences in baseline data from CT and echocardiography between two groups. In immediate postoperative echocardiography, SIS group showed significantly wider EOA (1.6±0.4 vs. 1.4±0.5 cm2; P=0.007) and lower mean trans-aortic pressure gradient (13.3±5.4 vs. 17.0±6.0 mmHg; P<0.001) compared with NMS group. In the next echocardiography, SIS group remained wider EOA (1.6±0.4 vs. 1.4±0.3 cm2; P<0.001) and lower mean trans-aortic pressure gradient (11.0±5.1 vs. 14.1±5.5 mmHg; P<0.001) than NMS group. There was no significant difference of paravalvular-leakage. (SIS group vs. NMS group; 1.3% vs. 5%; P=0.29).
Conclusion : SIS technique for AVR was related to wider EOA and low mean pressure gradient. This technique may be a reasonable option for AVR.
책임저자: Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Chee-hoon Lee, E-mail : liebemh@gmail.com