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SHR Neuro Cancer Cardio Lipid Metab Microb
Santarpino, G; Berretta, P; Kappert, U; Teoh, K; Mignosa, C; Meuris, B; Villa, E; Albertini, A; Carrel, TP; Misfeld, M; Martinelli, G; Phan, K; Miceli, A; Folliguet, T; Shrestha, M; Solinas, M; Andreas, M; Savini, C; Yan, T; Fischlein, T; Di Eusanio, M.
Minimally Invasive Redo Aortic Valve Replacement: Results From a Multicentric Registry (SURD-IR)
ANN THORAC SURG. 2020; 110(2): 553-557.
Doi: 10.1016/j.athoracsur.2019.11.033
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Andreas Martin
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- Abstract:
- Background. Reoperation for aortic valve replacement can be challenging and is usually associated with an increased risk for complications and mortality. The study aim was to report the results of a multicenter cohort of patients who underwent minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis. Methods. From 2007 to 2018 data from 3651 patients were retrospectively collected from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry. Of them, 63 patients who had previously undergone cardiac surgery representedthe studypopulation. In-hospital clinical and echocardiographic outcomes were recorded. Results. Mean age of the selected 63 patients was 75.3 +/- 7.8 years and logistic EuroSCORE 10.1. Surgery was performed by ministernotomy in 43 patients (68.3%) and by anterior right thoracotomy in 20 (31.7%); 31 patients (49.2%) received the Perceval valve (Livanova PLC, London, UK) and 32 (50.8%) the Intuity valve (Edwards Lifesciences, Irvine, CA). Mean cross-clamp time was 57.8 +/- 23.2 minutes and cardiopulmonary bypass time 95.0 +/- 34.3 minutes. Neither conversion to full sternotomy nor in-hospital deaths occurred. Postoperative events were ischemic cerebral events in 3 patients (4.8%), need for pacemaker implantation in 2 (3.6%), bleeding requiring reoperation in 5 (8.9%), and dialysis in 1 (1.6%). Median intensive care unit stay was 1 day, andmedian length of hospital stay was 10 days. On echocardiographic evaluation 1 patient showed a significant postoperative aortic regurgitation. Conclusions. Minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis is a safe and feasible treatment strategy, resulting in fast recovery and improved postoperative outcome with no mortality and an acceptable complication rate. (C) 2020 by The Society of Thoracic Surgeons.