Prognostic impact of small size sutureless prostheses: results for 241 patients from an international registry.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Santarpino Giuseppe, Lorusso Roberto, Concistrè Giovanni, Castillo Josè Cuenca, Argano Vincenzo, Royse Alistair, Nobre Angelo Lucas, Parrino Patrick, Bisleri Gianluigi, Baghai Max, Fischlein Theodor, Troise Giovanni, Mastrogiovanni Generoso, Fontaine Raphael, Pacini Davide, Minniti Giuseppe, Pappalardo Aniello, Hughes George Chad, Noirhomme Philippe, Grimaud Jean-Philippe, Scherner Maximilian, Muñoz Ignacio, Asimakopoulos George, Walker Antony, Zakova Daniela, Torella Michele, Vigano Giorgio, Connolly Mark, Dinges Christian, Corbi Pierre, Salvador Loris, Rinaldi Mauro, Maroto Luis, Heimansohn David, Ramlawi Basel, Glauber Mattia, D'Agnano Jlenia, Cosco Valeria, D'Anna Veronica, Solinas Marco
Аннотация
METHODS: The clinical data of the 241 patients who received a small size sutureless prosthesis from the Sorin Universal REgistry on Aortic Valve Replacement (SURE-AVR) (NCT02679404) were analysed at 30 days and at follow-up. The mean age was 75.5 ± 7.8 years (89.2% female); the mean Society of Thoracic Surgeons (STS) score was 4.2 ± 3.2%, and the preoperative NYHA class II or III score was 83.8%. A minimally invasive approach was performed in 52.7% of patients; concomitant procedures were performed in 27.8% of patients. Similar aortic clamping and cardiopulmonary bypass times were observed in the overall isolated cohort and the isolated minimally invasive cohort. The mean intensive care unit (ICU) stay was 2.4 ± 2.0 days and the total length of stay was 10.3 ± 6.1 days.
RESULTS: Three deaths were recorded at 30 days (1.2%), 2 for noncardiac causes. One patient experienced a myocardial infarction (0.4%) and 2 a nondisabling stroke (0.8%). 2 patients showed intraprosthetic leakage ≥ 2 and one patient para-prosthetic leakage ≥ 2; of these, one patient required reoperation with prosthesis removal. 4.1% of patients required a pacemaker implant. At a maximum follow-up of 8.1 years, 10 cardiovascular deaths, 4 valve related reinterventions (3 structural valve deterioration (SVD) requiring TAVI Valve-in-Valve, 1 endocarditis) occurred.
CONCLUSIONS: With their good clinical outcomes, sutureless prostheses represent a good alternative for patients with small annuli, who are at high risk for annular enlargement and anticoagulant therapy.
TRIAL REGISTRATION: Study number 587/2015.