Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement
Background: Sutureless aortic valve prostheses have proven to provide a significant decrease in procedural, cardiopulmonary bypass and cross-clamp time, leading to a significant reduction in mortality risk in elderly high-risk cohorts. In this study, we sought to review our institutional experience...
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MDPI AG
2023-03-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/3/737 |
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| author | Alina Zubarevich Marcin Szczechowicz Arian Arjomandi Rad Lukman Amanov Arjang Ruhparwar Alexander Weymann |
| author_facet | Alina Zubarevich Marcin Szczechowicz Arian Arjomandi Rad Lukman Amanov Arjang Ruhparwar Alexander Weymann |
| author_sort | Alina Zubarevich |
| collection | DOAJ |
| description | Background: Sutureless aortic valve prostheses have proven to provide a significant decrease in procedural, cardiopulmonary bypass and cross-clamp time, leading to a significant reduction in mortality risk in elderly high-risk cohorts. In this study, we sought to review our institutional experience on the sutureless aortic valve replacement (SU-AVR) and the concomitant mitral valve replacement (SMVR), comparing the combined conventional surgical aortic valve replacement (SAVR) with SMVR. Methods and Material: Between March 2018 and July 2022, 114 consecutive patients underwent a combined aortic and mitral valve replacement at our institution. We stratified the patients according to the operative procedures into two groups and matched them 1:2: Group 1 underwent a combined conventional SAVR and SMVR (n = 46), and Group 2 included combined SU-AVR with Perceval prosthesis and SMVR (n = 23). Results: No significant differences in the preoperative characteristics were present. SU-AVR combined with SMVR demonstrated excellent haemodynamic performance, comparable to that of SAVR plus SMVR, with median postoperative gradients over the aortic valve of 4 mmHg (IQR 3.0–4.0) in Group 1 and 4 mmHg (IQR 3.0–4.0) in Group 2 (<i>p</i> = 0.67). There was no significant difference in the occurrence of postoperative major adverse events such as death, stroke, myocardial infarction and kidney failure between the groups. There was also no significant difference in the permanent pacemaker implantation rate, paravalvular leakage or valve dislocation. We also could not detect any significant difference in postoperative mortality between the groups. Conclusions: SU-AVR has proven to be a reliable alternative to conventional valve prostheses in patients with multivalve disease undergoing combined aortic and mitral valve replacement, offering shorter procedural time and outstanding hemodynamic performance compared to the conventional surgical method. |
| first_indexed | 2024-03-11T06:17:16Z |
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| last_indexed | 2024-03-11T06:17:16Z |
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| series | Life |
| spelling | doaj.art-696ad9aa602a40e4a5b45949f4b6598d2023-11-17T12:11:40ZengMDPI AGLife2075-17292023-03-0113373710.3390/life13030737Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve ReplacementAlina Zubarevich0Marcin Szczechowicz1Arian Arjomandi Rad2Lukman Amanov3Arjang Ruhparwar4Alexander Weymann5Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, GermanyDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, GermanyClinical Academic Graduate School, University of Oxford, Oxford OX1 2JD, UKDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, GermanyDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, GermanyDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, GermanyBackground: Sutureless aortic valve prostheses have proven to provide a significant decrease in procedural, cardiopulmonary bypass and cross-clamp time, leading to a significant reduction in mortality risk in elderly high-risk cohorts. In this study, we sought to review our institutional experience on the sutureless aortic valve replacement (SU-AVR) and the concomitant mitral valve replacement (SMVR), comparing the combined conventional surgical aortic valve replacement (SAVR) with SMVR. Methods and Material: Between March 2018 and July 2022, 114 consecutive patients underwent a combined aortic and mitral valve replacement at our institution. We stratified the patients according to the operative procedures into two groups and matched them 1:2: Group 1 underwent a combined conventional SAVR and SMVR (n = 46), and Group 2 included combined SU-AVR with Perceval prosthesis and SMVR (n = 23). Results: No significant differences in the preoperative characteristics were present. SU-AVR combined with SMVR demonstrated excellent haemodynamic performance, comparable to that of SAVR plus SMVR, with median postoperative gradients over the aortic valve of 4 mmHg (IQR 3.0–4.0) in Group 1 and 4 mmHg (IQR 3.0–4.0) in Group 2 (<i>p</i> = 0.67). There was no significant difference in the occurrence of postoperative major adverse events such as death, stroke, myocardial infarction and kidney failure between the groups. There was also no significant difference in the permanent pacemaker implantation rate, paravalvular leakage or valve dislocation. We also could not detect any significant difference in postoperative mortality between the groups. Conclusions: SU-AVR has proven to be a reliable alternative to conventional valve prostheses in patients with multivalve disease undergoing combined aortic and mitral valve replacement, offering shorter procedural time and outstanding hemodynamic performance compared to the conventional surgical method.https://www.mdpi.com/2075-1729/13/3/737Percevalcombined proceduresSAVRSMVRSU-AVRmultivalve disease |
| spellingShingle | Alina Zubarevich Marcin Szczechowicz Arian Arjomandi Rad Lukman Amanov Arjang Ruhparwar Alexander Weymann Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement Life Perceval combined procedures SAVR SMVR SU-AVR multivalve disease |
| title | Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement |
| title_full | Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement |
| title_fullStr | Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement |
| title_full_unstemmed | Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement |
| title_short | Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement |
| title_sort | conventional biological versus sutureless aortic valve prostheses in combined aortic and mitral valve replacement |
| topic | Perceval combined procedures SAVR SMVR SU-AVR multivalve disease |
| url | https://www.mdpi.com/2075-1729/13/3/737 |
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