초록접수 현황
| 20F-075 | 구연 발표 |
Initial experience with right anterior minithoracotomy sutureless aortic valve replacement
Jae Suk Yoo, Hee Moon Lee, Sang Yoon Yeom, Dong Jin Kim, Kwang Ree Cho
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital
Purpose : To assess the safety and efficacy of right minithoracotomy aortic valve replacement with a sutureless bioprosthetisis performed at a single institution.
Methods : We performed an analysis of the first 40 consecutive patients (aged 76.8 ± 6.6 years; logistic European System for Cardiac Operative Risk Evaluation 3.10 ± 1.57) who underwent sutureless valve (Perceval S, LivaNova, Italy) implantation via a right minithoracotomy by a single surgeon between January 2018 and July 2020 (Figure 1). Echocardiographic and clinical outcomes were analyzed. The learning curve effect was analyzed by caridiopulmonary bypass (CPB) and aortic crossclmaping (ACC) times.
Results : The sutureless valve was implanted successfully in 100% of patients without any conversion to sternotomy. Recollapsing of the prosthesis was required in two patients for malpositioning. There was no in-hospital death. Patent foramen ovale closure was combined in two pateints. Bleeding reoperation was required in one patient (2.5%). Mean and peak transvalvular pressure gradients were 11.6 ± 2.6 mmHg and 21.9 ± 6.4 mmHg at discharge, respectively. In two patients (5.0%), permanent pacemaker implantation was necessary. No thromboembolic events or bleedings related to the bioprosthesis were observed. Mean CPB and ACC times were 94.7 ± 19.3 and 59.3 ± 15.5 minutes, respectively, with significant decrease in both times based on chronological date of operation (Figure 2).
Conclusion : Right minithoracotomy sutureless aortic valve replacement is shown to be safe and feasible. We notice significantly decreased CPB and ACC times as experience is gained. The long-term durability of this prosthesis has yet to be determined.
Methods : We performed an analysis of the first 40 consecutive patients (aged 76.8 ± 6.6 years; logistic European System for Cardiac Operative Risk Evaluation 3.10 ± 1.57) who underwent sutureless valve (Perceval S, LivaNova, Italy) implantation via a right minithoracotomy by a single surgeon between January 2018 and July 2020 (Figure 1). Echocardiographic and clinical outcomes were analyzed. The learning curve effect was analyzed by caridiopulmonary bypass (CPB) and aortic crossclmaping (ACC) times.
Results : The sutureless valve was implanted successfully in 100% of patients without any conversion to sternotomy. Recollapsing of the prosthesis was required in two patients for malpositioning. There was no in-hospital death. Patent foramen ovale closure was combined in two pateints. Bleeding reoperation was required in one patient (2.5%). Mean and peak transvalvular pressure gradients were 11.6 ± 2.6 mmHg and 21.9 ± 6.4 mmHg at discharge, respectively. In two patients (5.0%), permanent pacemaker implantation was necessary. No thromboembolic events or bleedings related to the bioprosthesis were observed. Mean CPB and ACC times were 94.7 ± 19.3 and 59.3 ± 15.5 minutes, respectively, with significant decrease in both times based on chronological date of operation (Figure 2).
Conclusion : Right minithoracotomy sutureless aortic valve replacement is shown to be safe and feasible. We notice significantly decreased CPB and ACC times as experience is gained. The long-term durability of this prosthesis has yet to be determined.
책임저자: Jae Suk Yoo
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital
발표자: Jae Suk Yoo, E-mail : mdyoo77@gmail.com