Sutureless and standart bioprothesis in aortic valve stenosis. Four-year follow-up
Abstract
Aim. Aortic valve replacement is a "gold standard" in the surgical treatment of aortic stenosis. At the same time, an increasing number of patients require combined surgical interventions in addition to aortic valve replacement. Currently, surgical mortality due to isolated aortic stenosis varies between 3–8% in low-risk patients under 70 years old and around 5–11% in "elderly patients", rising up to 15% in cases of combined heart surgery. Using of sutureless valves for open implantation requires careful analysis of the immediate and long-term results of their implantation and comparison with the results of standard methods of treatment.
Material and methods. The study was design as a prospective-retrospective study to evaluate results of using different types of biological prostheses in case of isolated aortic valve stenosis and together with concomitant cardiac pathology. The study included patients older than 65 years with aortic stenosis, who underwent aortic valve replacement. The patients were divided into two groups. The comparison was carried out by the following criteria: intraoperative data, the number and nature of postoperative complications, survival, freedom from ischemic events and from reoperation, dynamics of transaortic gradient, hemodynamic characteristics for the entire evaluation period (4 years).
Results. In the group of patients with implanted sutureless valves, there was a smaller number of postoperative complications, faster recovery, significantly lower mortality rates, higher freedom from valve-related complications in postoperative period.
Conclusions. Тhe use of sutureless prostheses is justified for the aortic valve replacement and is safer compared to standard valves, in the absence of contraindications. Surgical treatment of patients with aortic stenosis using sutureless valves led to significant clinical improvement in most of them, both in the functional class and in the threshold of tolerance to physical activity. The level of typical complications related to valve replacement was significantly lower.
Simplicity and reproducibility of the procedure, fast learning process can certainly contribute surgeons to wider and more active implementation of this technology in clinical practice.
Keywords:aortic valve replacement, sutureless heart valve prosthesis, Perceval S
For citation: Borisov I.A., Dalinin V.V., Simonenko V.B., Sergoventsev A.A., Kraynyukov P.E. Sutureless and standart bioprothesis in aortic valve stenosis. Four years follow-up. Clin Experiment Surg. Petrovsky J. 2019; 7 (1): 44–53. doi: 10.24411/2308-1198-2019-11006. (in Russian)
Received 14.05.2018. Accepted 06.02.2019.
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