Salvatore Nicolardi, Gabriele De Masi De Luca, Federica Mangia, Cosimo Angelo Greco, Salvatore Zaccaria
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引用次数: 0
摘要
对使用生物本托尔导管的患者进行主动脉瓣置换术(AVR)是一项非常具有挑战性的工作,尤其是如果之前曾发生过心内膜炎,则会导致严重的发病率和死亡率。我们报告了一例使用生物本托尔导管(Carpentier-Edwards Perimount Magna Ease 25 主动脉瓣和 Hemashield 30 主动脉导管)的高龄患者的无缝合自体瓣膜置换术,该患者的主动脉假体瓣膜发生了心内膜炎。我们认为,对于手术风险较高的老年患者来说,无缝线主动脉瓣置换术是重新手术的最佳选择,因为它可以轻松快速地部署植入物,避免在脆弱的主动脉瓣环上锚定缝线,并缩短心肺和主动脉交叉钳夹时间。在这种情况下,不仅应将其视为传统人工瓣膜的一种安全有效的替代方法,而且在某些情况下还应将其视为经导管瓣中瓣解决方案的一种安全有效的替代方法。
Sutureless and Rapid Deployment Prosthesis in Redo-Bentall Endocarditis.
Aortic valve replacement (AVR) in a patient with a bio-Bentall conduit can be very challenging, especially if there was a previous endocarditis process for significant morbidity and mortality. We report a case of sutureless AVR in an old patient with a bio-Bentall conduit (Carpentier-Edwards Perimount Magna Ease 25 aortic valve and Hemashield 30 aortic conduit), who developed an endocarditis on aortic prosthesis valve. We believe that sutureless AVR is the best option for redo-operation in older patients with a high surgical risk because it allows for easy rapid deployment implantation, avoids anchoring sutures on a fragile aortic anulus, and reduces cardiopulmonary and aortic cross-clamp times. In this setting, it should be considered as a safe and valid alternative not only to traditional prosthesis but also in selected cases to transcatheter valve-in-valve solutions.