초록접수 현황
| 17F-031 | 포스터 발표 |
Initial Experience on Sutureless Aortic Valve Replacement
Jae-Bum Kim, Sae Young Choi, Jae Hyun Kim
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
Purpose : Prolonged aortic cross clamping (ACC) can increase mortality and morbidity after aortic valve replacement (AVR) in elderly and high-risk comorbid patients. Sutureless AVR have the potential to shorten ACC time. We describe the initial experience of sutureless AVR.
Methods : Between December 2014 and July 2017, 7 high-risk patients (mean age, 74.8 years; 6 females; mean EuroSCORE II, 6.58; NYHA class III and IV, 83.3%) with symptomatic severe aortic stenosis were operated using sutureless (Perceval S, Sorin) valve prostheses. Concomitant procedures were coronary artery bypass graft (n = 3), mitral and tricuspid valve repair and maze operation (n = 1).
Results : There were one in-hospital deaths (14.3%). The cause of the death was idiopathic thrombocytopenic purpura. Valve-related mortality or morbidity was not occurred. The mean cardiopulmonary bypass (CPB) and ACC time were 82 +/- 32 and 116 +/- 33 minutes. Postoperative echocardiography revealed no paravalvular leakage in all patients. The transvalvular gradient at discharge was 9 +/- 2 mm Hg (mean) and 18 +/- 5 mm Hg (peak). The other patients discharged without a complication and were in good condition.
Conclusion : Sutureless AVR can be implanted safely with favorable early hemodynamics. Reduction of CPB and ACC time seems to be possible with increasing experience. Sutureless AVR can be a recommended option for the high-risk comorbid patients.
Methods : Between December 2014 and July 2017, 7 high-risk patients (mean age, 74.8 years; 6 females; mean EuroSCORE II, 6.58; NYHA class III and IV, 83.3%) with symptomatic severe aortic stenosis were operated using sutureless (Perceval S, Sorin) valve prostheses. Concomitant procedures were coronary artery bypass graft (n = 3), mitral and tricuspid valve repair and maze operation (n = 1).
Results : There were one in-hospital deaths (14.3%). The cause of the death was idiopathic thrombocytopenic purpura. Valve-related mortality or morbidity was not occurred. The mean cardiopulmonary bypass (CPB) and ACC time were 82 +/- 32 and 116 +/- 33 minutes. Postoperative echocardiography revealed no paravalvular leakage in all patients. The transvalvular gradient at discharge was 9 +/- 2 mm Hg (mean) and 18 +/- 5 mm Hg (peak). The other patients discharged without a complication and were in good condition.
Conclusion : Sutureless AVR can be implanted safely with favorable early hemodynamics. Reduction of CPB and ACC time seems to be possible with increasing experience. Sutureless AVR can be a recommended option for the high-risk comorbid patients.
책임저자: Jae Hyun Kim
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
발표자: Jae Hyun Kim, E-mail : jaemax31@gmail.com