为感染性心内膜炎或主动脉瓣功能不全的复杂患者实施快速部署主动脉瓣植入术。

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-07-16 DOI:10.1186/s13019-024-02967-6
Kálmán Benke, Viktor Bánhegyi, Edina Korca, Gábor Veres, Yuliana Yakobus, Meradjoddin Matin, Gábor Szabó
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引用次数: 0

摘要

背景:缩短主动脉瓣感染性心内膜炎(IE)和主动脉瓣关闭不全(AVI)患者的手术时间并改善其预后的新型人工瓣膜和手术方法至关重要。本研究旨在评估在标签外适应症中使用 EDWARDS INTUITY Rapid-Deployment AV 人工瓣膜治疗 AV IE 或 AVI 患者的疗效:这项单中心回顾性研究分析了因房室 IE 或反流而接受 EDWARDS INTUITY Rapid-Deployment AV 假体房室置换术的患者的数据。(结果:结果: AVI 组的心肺机时间(111.3 ± 20.7 分钟)明显短于 IE 组(171.9 ± 52.4 分钟)(P = 0.02)。主动脉交叉钳夹也有类似趋势(AVI 组为 73.7 ± 9.9 分钟,IE 组为 113.4 ± 35.6 分钟)(P = 0.02)。AVI 组的重症监护室住院时间(3.8 ± 2.6 天)也比 IE 组(16.9 ± 8.9 天)短(p = 0.005)。术后超声心动图检查显示,没有任何患者出现瓣膜旁漏或明显的瓣膜功能障碍。一名患者术后死于吸入性肺炎:INTUITY瓣膜是复杂房室IE和AVI手术的安全选择。有必要对更大的患者群体进行进一步的前瞻性研究,以证实这些发现并探索这种方法的长期益处。
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Rapid deployment aortic valve implantation in complex patients with infective endocarditis or aortic valve insufficiency.

Background: New prosthetic valves and surgical approaches that shorten operation time and improve the outcome of patients with aortic valve (AV) infective endocarditis (IE) and AV insufficiency (AVI) are crucial. The aim of this study was to evaluate the outcome of patients with AV IE or AVI treated with the EDWARDS INTUITY Rapid-Deployment AV prosthesis for this off-label indication.

Methods: This single-centre retrospective study analyzed data from patients who underwent AV replacement with the EDWARDS INTUITY Rapid-Deployment AV prosthesis for AV IE or regurgitation. (n = 8 for IE and n = 6 for AVI).

Results: Heart-lung machine times were significantly shorter in the AVI group (111.3 ± 20.7 min) compared to the IE group (171.9 ± 52.4 min) (p = 0.02). Aortic cross-clamp followed a similar trend (73.7 ± 9.9 min for AVI vs. 113.4 ± 35.6 min for IE) (p = 0.02). The length of ICU stay was also shorter in the AVI group (3.8 ± 2.6 days) compared to the IE group (16.9 ± 8.9 days) (p = 0.005). Postoperative echocardiography revealed no paravalvular leakage or significant valvular dysfunction in any patient. One patient died postoperatively from aspiration pneumonia.

Conclusion: The INTUITY valve demonstrates as a safe option for complex AV IE and AVI surgery. Further prospective studies with larger patient cohorts are necessary to confirm these findings and explore the long-term benefits of this approach.

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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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