Open AccessSutureless bioprothesis in aortic valve surgery
Author(s) -
I Borisov,
V. V. Dalinin,
В. Б. Симоненко,
A. A. Sergovencev,
P. E. Kraynukov
Publication year - 2020
Publication title -
kliničeskaâ medicina
Language(s) - English
Resource type - Journals
eISSN - 2412-1339
pISSN - 0023-2149
DOI - 10.30629/0023-2149-2020-98-6-440-448
Subject(s) - medicine , aortic valve replacement , stenosis , surgery , aortic valve , concomitant , aortic valve stenosis , gold standard (test) , valve replacement , cardiology
Objective:aortic valve replacement is a «gold standard» in the surgical treatment of aortic stenosis. At the same time, anincreasingnumber of patients require combined surgical interventions in addition to aortic valve replacement. Currently,surgicalmortalityin 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. The use of sutureless valves for open implantationrequirescarefulanalysis of the immediate and long-term results of their implantation and comparison to the results of standardmethods of treatment.Materialand methods . The study was designed as a prospective-retrospective study for evaluation ofresults of di erent types of biological prostheses use in case of isolated aortic valve stenosis and together with concomitantcardiacpathology.Thestudyincluded patients over 65 years old with aortic stenosis, who underwent aortic valve replacement.Thepatients were divided into two groups. The comparison was carried out by the following criteria: intraoperative data, thenumber and nature of postoperative complications, survival, freedom from ischemic events and from reoperation, dynamics oftransaortic gradient, hemodynamic characteristics for the entire evaluation period (5 years).Results. In the group of patientswith implanted sutureless valves, there was a smaller number of postoperative complications, faster recovery, significantlylower mortality rates, higher freedom from valve-related complications in postoperative period.Conclusions. Theuse of sutureless prostheses is justified for the aortic valve replacement and is safer compared to standardvalves, in the absence of contraindications. Surgical treatment of patients with aortic stenosis with the use of sutureless valvesled to significant clinical improvement in most of them, both in the functional class and in the threshold of tolerance to physicalactivity.Thelevel of typical valve replacement complications was significantly lower. Simplicity and reproducibility of theprocedure,fast learning process can certainly contribute s to wider and more active implementation of this technology inclinical practice.