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Geometric Ring Annuloplasty for Aortic Valve Repair During Aortic Aneurysm Surgery: Two-Year Clinical Trial Results
JS. Rankin, D. Mazzitelli, T. Fischlein, YH. Choi, J. Pirk, S. Pfeiffer, LM. Wei, V. Badhwar,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
- MeSH
- anuloplastika srdeční chlopně * škodlivé účinky přístrojové vybavení mortalita statistika a číselné údaje MeSH
- aortální aneurysma mortalita chirurgie MeSH
- aortální chlopeň chirurgie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pooperační komplikace MeSH
- protézy - design MeSH
- reoperace MeSH
- senioři MeSH
- srdeční chlopně umělé škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: An aortic annuloplasty ring could be useful for aortic valve repair. This trial evaluated intermediate-term outcomes of internal geometric ring annuloplasty for repair of trileaflet and bicuspid aortic insufficiency associated with ascending aortic and/or aortic root aneurysms. METHODS: Under regulatory supervision, 47 patients with aortic insufficiency and ascending aortic (n = 22) and/or aortic root (n = 25) aneurysms were managed with aortic valve repair and aneurysm resection. Valve repair was performed using trileaflet (n = 40) or bicuspid (n = 7) internal geometric rings, together with leaflet reconstruction. Ascending aortic and/or remodeling root replacements were accomplished with Dacron grafts 5 to 7 mm larger than the rings. An Echo Core Lab provided independent echocardiographic assessments, and changes over time were evaluated by Friedman tests. RESULTS: Mean ± SD age was 60 ± 14 years, 57% (27/47) were male, 15% (7/47) had bicuspid valves, 87% (41/47) had moderate-to-severe aortic insufficiency, and 13% (6/47) had mild aortic insufficiency. All patients had annular dilatation, with a mean ± SD of 26.5 ± 2.6 mm before repair, and mean ± SD ring sizes were 21.7 ± 1.7 mm. Follow-up was 42 months (mean = 27 months). No operative mortality or valve-related complications occurred. Two patients died beyond 1 year from nonvalve-related causes. One patient required valve replacement for repair failure. Survival free of complications or valve replacement was 94% at 2 years. Significant reduction in aortic insufficiency and New York Heart Association class were observed (P < 0.0001), and valve gradients remained low. No heart block or direct ring complications occurred. CONCLUSIONS: In preliminary regulatory studies, aortic ring annuloplasty seemed safe and effective during aortic aneurysm surgery. This approach could help standardize aortic valve repair.
Department of Cardiac and Thoracic Surgery University of Köln Köln Germany
Department of Cardiac Surgery Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiac Surgery Klinikum Bogenhausen Munich Germany
Citace poskytuje Crossref.org
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