Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular · 2019
[Safety and feasibility of conservative aortic valve surgery: single center experience].
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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J Cerqueira Rui, Quintal Jéni, Moreira Soraia, A Saraiva Francisca, J Amorim Mário, Almeida Jorge, Pinho Paulo, Leite-Moreira Adelino
Аннотация
BACKGROUND: In selected cases, aortic valve repair (RVAo) is an alternative to prostesic aortic valve replacement.
AIM: To compare mid-term survival, need of reoperation and echocardiographic findings associated with RVAo.
METHODS: Retrospective single-center cohort study including consecutive patients younger than 70 years-old, with non-stenotic aortic valve disease, who underwent RVAo between 2012 and 2017. A comparison was made with a group of patients who underwent mechanical aortic valve replacement (SVAo) in the same period. The groups were characterized and compared using Chi-Square and t-tests for independent samples and survival and reoperation were analyzed using Kaplan-Meier curves and Cox regressions.
RESULTS: We included 72 patients submitted to RVAo. Mean follow-up time was 4 years, maximum 7. Although the mean age was relatively low (47±13 years), patients undergoing RVAo presented a lower prevalence of rheumatic etiology (3%). The cardiopulmonary bypass (148±74 minutes) and cross clamping aortic times (108±52 minutes) are the usual times for this type of surgery and similar to those of the comparing group (SVAo). In the echocardiographic follow-up (median of 3 months), we verified a left ventricular mass regression of 21% and a prevalence of aortic insufficiency of 4%. At 7 years, cumulative survival and freedom from reoperation of patients undergoing RVAo were 98.8% and 97.6%, respectively.
CONCLUSION: RVAo can be a safe and effective alternative, with good mid-term results if patient selection is judicious.
AIM: To compare mid-term survival, need of reoperation and echocardiographic findings associated with RVAo.
METHODS: Retrospective single-center cohort study including consecutive patients younger than 70 years-old, with non-stenotic aortic valve disease, who underwent RVAo between 2012 and 2017. A comparison was made with a group of patients who underwent mechanical aortic valve replacement (SVAo) in the same period. The groups were characterized and compared using Chi-Square and t-tests for independent samples and survival and reoperation were analyzed using Kaplan-Meier curves and Cox regressions.
RESULTS: We included 72 patients submitted to RVAo. Mean follow-up time was 4 years, maximum 7. Although the mean age was relatively low (47±13 years), patients undergoing RVAo presented a lower prevalence of rheumatic etiology (3%). The cardiopulmonary bypass (148±74 minutes) and cross clamping aortic times (108±52 minutes) are the usual times for this type of surgery and similar to those of the comparing group (SVAo). In the echocardiographic follow-up (median of 3 months), we verified a left ventricular mass regression of 21% and a prevalence of aortic insufficiency of 4%. At 7 years, cumulative survival and freedom from reoperation of patients undergoing RVAo were 98.8% and 97.6%, respectively.
CONCLUSION: RVAo can be a safe and effective alternative, with good mid-term results if patient selection is judicious.