초록접수 현황
| 14F-128 | 구연 발표 |
Do Suture Techniques Affect Hemodynamic Performance of the Prosthetic Valves in Supra-annular Aortic Valve Replacement?
최종범, 김종헌, 차병기, 김경화, 이정문, 구자홍
전북대학교 의학전문대학원 흉부외과학교실
Background : A supra-annular aortic valve prosthesis is commonly used for aortic valve replacement in patients with a small aortic annulus. However, whether suture techniques affect the valve hemodynamics or not has been rarely studied. The aim of this study is to compare valve hemodynamics between 3 different suture techniques
Methods : We reviewed 161 patients undergoing aortic valve replacement using three mechanical valves and two bioprosthetic valves between November 2007 and June 2014. Non-everting, pledgeted mattress suture were used in 46 patients (28.6%), continuous suture in 95 patients (59.0%), and simple interrupted suture in 20 patients (12.4%). Transthoracic echocardiograms were obtained at one or more months after surgery. We compared the valve hemodynamics between 3 suture groups.
Results : There were insignificant differences in peak pressure gradient (32.9±14.3 mmHg, 29.4±12.5 mmHg, 29.1 ±14.7 mmHg, respectively; p=0.306), mean pressure gradient (17.8 ±7.7 mmHg, 16.2 ±7.1 mmHg, 16.0±9.1 mmHg, respectively; p=0.432), aortic valve area (1.84±0.45 cm2, 2.00±0.50 cm2, 1.87±0.40 cm2, respectively; p=0.249), and indexed aortic valve area (1.13±0.33 cm2/m2, 1.26±0.31 cm2/m2, 1.23±0.28 cm2/m2, respectively; p=0.209). The prosthetic valve hemodynamics in patients with a small aortic prosthesis (19-21 mm) showed the similar outcomes. The incidence of moderate prosthesis-patient mismatch was 1 (3.0 %) in the non-everting mattress suture group and 1 (1.7%) in the continuous suture group. There were no patients who had severe patient-prosthesis mismatch.
Conclusion : Suture technique did not affect valve hemodynamics in supra-annular aortic valve replacement. The continuous suture technique and the simple interrupted suture technique, which were used to eradicate the medially rolled annular tissue, did not revealed better prosthetic valve hemodynamics compared with the non-everting mattress suture, especially in patients who underwent supra-annular replacement using a 19-21 mm prosthetic valve.
Methods : We reviewed 161 patients undergoing aortic valve replacement using three mechanical valves and two bioprosthetic valves between November 2007 and June 2014. Non-everting, pledgeted mattress suture were used in 46 patients (28.6%), continuous suture in 95 patients (59.0%), and simple interrupted suture in 20 patients (12.4%). Transthoracic echocardiograms were obtained at one or more months after surgery. We compared the valve hemodynamics between 3 suture groups.
Results : There were insignificant differences in peak pressure gradient (32.9±14.3 mmHg, 29.4±12.5 mmHg, 29.1 ±14.7 mmHg, respectively; p=0.306), mean pressure gradient (17.8 ±7.7 mmHg, 16.2 ±7.1 mmHg, 16.0±9.1 mmHg, respectively; p=0.432), aortic valve area (1.84±0.45 cm2, 2.00±0.50 cm2, 1.87±0.40 cm2, respectively; p=0.249), and indexed aortic valve area (1.13±0.33 cm2/m2, 1.26±0.31 cm2/m2, 1.23±0.28 cm2/m2, respectively; p=0.209). The prosthetic valve hemodynamics in patients with a small aortic prosthesis (19-21 mm) showed the similar outcomes. The incidence of moderate prosthesis-patient mismatch was 1 (3.0 %) in the non-everting mattress suture group and 1 (1.7%) in the continuous suture group. There were no patients who had severe patient-prosthesis mismatch.
Conclusion : Suture technique did not affect valve hemodynamics in supra-annular aortic valve replacement. The continuous suture technique and the simple interrupted suture technique, which were used to eradicate the medially rolled annular tissue, did not revealed better prosthetic valve hemodynamics compared with the non-everting mattress suture, especially in patients who underwent supra-annular replacement using a 19-21 mm prosthetic valve.
책임저자: 최종범
전북대학교 의학전문대학원 흉부외과학교실
연락처 : 김종헌, Tel: 063-250-1485 , E-mail : kim77jh@gmail.com
