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Satoh A, Ryomoto M, Sekiya N, Sakaguchi T. An infra-annular malposition of the Perceval sutureless aortic valve. Eur J Cardiothorac Surg 2020; 59:ezaa272. [PMID: 32949131 DOI: 10.1093/ejcts/ezaa272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/25/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ayaka Satoh
- Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Masaaki Ryomoto
- Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Naosumi Sekiya
- Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Taichi Sakaguchi
- Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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Ellouze M, Mazine A, Carrier M, Bouchard D. Sutureless and Transcatheter Aortic Valve Replacement: When Rivals Become Allies. Semin Thorac Cardiovasc Surg 2019; 32:427-430. [PMID: 31330180 DOI: 10.1053/j.semtcvs.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/06/2019] [Indexed: 11/11/2022]
Abstract
In recent years, sutureless aortic valve replacement (SU-AVR) and transcatheter aortic valve replacement (TAVR) have emerged as viable alternatives to standard surgical aortic valve replacement (AVR) in higher risk patients. We report 7 cases in which SU-AVR and TAVR were used as bailout procedures for each other. Between June 2011 and August 2018, 626 patients underwent SU-AVR with the Perceval S prosthesis, and 588 patients underwent TAVR at the Montreal Heart Institute. Herein, we report the cases of 7 patients who underwent both procedures within a short time frame: 3 patients who underwent SU-AVR with a Perceval prosthesis after a failed TAVR procedure, 3 patients who underwent TAVR after degeneration of a surgically implanted Perceval sutureless prosthesis, and 1 patient who was scheduled for multiple percutaneous interventions-including TAVR, right coronary angioplasty, atrial fibrillation ablation with left atrial appendage occlusion-who suffered a periprocedural complication requiring an emergent surgery, during which a Perceval sutureless prosthesis was deployed. All patients were discharged home alive. Two patients suffered a complete heart block requiring permanent pacemaker implantation. We demonstrate that SU-AVR with the Perceval S prosthesis and TAVR are complementary procedures within the therapeutic armamentarium to treat aortic valve disease in higher risk patients. Specifically, valve-in-valve TAVR is an attractive option in the setting of Perceval prosthesis degeneration, whereas SU-AVR is a useful bailout option in the context of periprocedural failure of a TAVR.
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Affiliation(s)
- Mariam Ellouze
- Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada
| | - Amine Mazine
- Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada
| | - Michel Carrier
- Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada
| | - Denis Bouchard
- Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada.
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Kosmas I, Iakovou I, Leontiadis E, Sbarouni E, Georgiadou P, Bousoula E, Aravanis N, Stratinaki M, Voudris V, Mpalanika M. The first transcatheter valve-in-valve implantation of a self-expandable valve for the treatment of a degenerated sutureless aortic bioprosthesis. Hellenic J Cardiol 2019; 61:49-50. [PMID: 31039413 DOI: 10.1016/j.hjc.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/05/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- I Kosmas
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece.
| | - I Iakovou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Leontiadis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Sbarouni
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - P Georgiadou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Bousoula
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - N Aravanis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Stratinaki
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - V Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Mpalanika
- Department of Anaesthesiology, Onassis Cardiac Surgery Center, Greece
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Lin CY, Lee HA, Lin PJ, Wang CL, Hung KC, Tsai FC. Sutureless aortic bioprosthesis replacement in elderly Asian patients with aortic stenosis: Experience in a single institution. Biomed J 2018; 41:265-272. [PMID: 30348270 PMCID: PMC6198014 DOI: 10.1016/j.bj.2018.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 03/22/2018] [Accepted: 04/27/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Sutureless aortic valve replacement (SU-AVR) has emerged as a promising alternative for the treatment of patients with aortic valve stenosis. This study aims to assess the safety and efficacy of SU-AVR in an elderly Asian population. METHODS From June 2015 to May 2016, 15 adults with severe aortic stenosis (9 females) with a median age of 79 years underwent Perceval sutureless bioprosthesis (LivaNova, UK) implantation in a single Taiwanese institution; peri-operative recovery, clinical improvement, and valve performance were analyzed. RESULTS Three (20%) patients underwent concomitant procedures (coronary artery bypass grafting, 1 patient; maze, 2 patients) and 6/12 (50%) patients underwent J-ministernotomy for isolated SU-AVR. Median cardiopulmonary bypass and cross-clamp time were 105 min and 69 min, respectively. All sutureless bioprosthesis were implanted successfully without conversion to a traditional valve, but 2 patients (13.3%) need intraoperative valve repositioning because of paravalvular leakage. Median extubation time and intensive care unit stay were 5 h and 2 days, respectively. One patient experienced in-hospital mortality due to sudden collapse thought secondary to high degree atrioventricular block. Serial echocardiographic evaluations were performed preoperatively and at 1, 3, and 6 months postoperatively. The final echocardiographic exams showed nothing greater than mild aortic insufficiency and the median mean trans-valvular gradient was 13.2 (range, 6.0-26.3) mmHg. CONCLUSIONS By simplified procedure and improved hemodynamics, SU-AVR can be implanted safely in elderly Asian population with excellent valvular performance.
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Affiliation(s)
- Chun-Yu Lin
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-An Lee
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pyng-Jing Lin
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Li Wang
- Department of Cardiovascular Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Chun Hung
- Department of Cardiovascular Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Feng-Chun Tsai
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Castrodeza J, Amat-Santos IJ, Serra V, Nombela-Franco L, Brinster DR, Gutiérrez-Ibanes E, Rojas P, Tornos P, Carnero M, Cortes C, Tobar J, Di Stefano S, Gomez I, San Román JA. Therapeutic alternatives after aborted sternotomy at the time of surgical aortic valve replacement in the TAVI Era-Five centre experience and systematic review. Int J Cardiol 2016; 223:1019-1024. [PMID: 27592044 DOI: 10.1016/j.ijcard.2016.08.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era. METHODS Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed. RESULTS A total of 31 patients (71% males, 74±8years, LogEuroSCORE 11.9±7.4%) suffered an AbS (0.19% of all sternotomies). Main reasons for Abs included previously unknown porcelain aorta (PAo) in 83.9%, mediastinal fibrosis due to radiotherapy in 12.9%, and chronic mediastinitis in 3.2%. Median time between AbS and next intervention was 2.3months (IQR: 0.7-5.8) with no mortality within this period. Only a case was managed with open surgery. In 30 patients (96.8%) TAVI was performed with a rate of success of 86.7%. Three patients (9.7%) presented in-hospital death and 17 (54.8%) had in-hospital complications including heart failure (9.6%), major bleeding (6.9%), and acute kidney injury (9.6%). Older patients (76±8 vs. 70±8years, p=0.045), previous cardiac surgery (60% vs. 15.4%, p=0.029), and shorter time from AbS to next intervention (5.1±5 vs. 1±0.7months, p=0.001) were related to higher six-month mortality (22.6%). CONCLUSIONS The main reason for AbS was PAo. This entity was associated to a higher rate of complications and mortality, especially in older patients and with prior cardiac surgery. A preventive strategy in these subgroups might be based on imaging evaluation. TAVI was the most extended therapy.
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Affiliation(s)
- Javier Castrodeza
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Ignacio J Amat-Santos
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain.
| | - Vicenç Serra
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Luis Nombela-Franco
- Cardiology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | | | | | - Paol Rojas
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Pilar Tornos
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Manuel Carnero
- Cardiac Surgery Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Carlos Cortes
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Tobar
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Salvatore Di Stefano
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gomez
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - José A San Román
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
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Vola M, Fuzellier JF, Campisi S, Roche F, Favre JP, Isaaz K, Morel J, Gerbay A. Closed chest human aortic valve removal and replacement: Technical feasibility and one year follow-up. Int J Cardiol 2016; 211:71-8. [PMID: 26977583 DOI: 10.1016/j.ijcard.2016.02.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 02/11/2016] [Accepted: 02/28/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Minimally invasive aortic valve replacement has so far required a minithoracotomy or a ministernotomy. We present here the first series of totally endoscopic aortic valve replacement (TEAVR). METHODS Between June 2013 and April 2015, 14 consecutive patients (12 males, mean age=76 ± 5.4 years) with a mean EuroSCORE II of 2.72 ± 0.03% underwent TEAVR. A five trocar setting was used in all patients: after ablation of the native valve, a Nitinol stented sutureless 3f Enable Medtronic valve, compressed into the main working trocar, was introduced into the thorax and then expanded in the aortic root. RESULTS Among the 14 patients, a thoracoscopic approach was successful in 13 (92.8%) and conversion into an open surgery using the right anterior minithoracotomy was necessary to close the aortotomy in one case. Mean cross-clamping and cardiopulmonary (CPB) times were 112 ± 18 and 161 ± 31 min, respectively. All patients left the surgical unit within 8 days after the operation without any paravalvular leakage. There was no paravalvular regurgitation, conductive block or any major adverse event at a mean follow-up of 10 ± 4 months (range 2-16). CONCLUSIONS TEAVR is feasible and safe in a selected subset of patients. Closed chest surgery has the potential to become the future approach of the isolated aortic valve replacement in low risk patients but further technical refinement and larger studies are necessary to reduce operative durations and enhance reproducibility.
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Affiliation(s)
- Marco Vola
- Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France.
| | - Jean-François Fuzellier
- Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France
| | - Salvatore Campisi
- Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France
| | - Fréderic Roche
- Clinical Physiology Department, Cardiac Rehabilitation, EA SNA EPIS, UJM Saint Etienne, France
| | - Jean-Pierre Favre
- Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France
| | - Karl Isaaz
- Cardiology Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France
| | - Jérôme Morel
- Anaesthesiology and Reanimation Department, University Hospital, St-Etienne, France
| | - Antoine Gerbay
- Cardiology Unit, Cardiovascular Diseases Department, University Hospital, St-Etienne, France
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