Sutureless aortic valve prosthesis: A fast option for a mini-invasive approach

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
G Santarpino ◽  
S Pfeiffer ◽  
M Herold ◽  
T Fischlein
2021 ◽  

Reoperations for a dysfunctional mechanical aortic valve prosthesis are usually performed with a repeat sternotomy. Reopening the chest may be associated with a heart structure tear, bleeding, excessive transfusion, and a possible unfavorable outcome. Experience performing a redo aortic valve replacement with a minimally invasive approach and avoiding lysis of the pericardial adhesions is growing. We describe a redo aortic valve replacement procedure performed because of subvalvular pannus formation in a patient with a mechanical prosthesis. A partial J-shaped hemisternotomy at the 3rd intercostal space was performed; the ascending aorta was exposed and the valve was replaced with a sutureless bioprosthesis. The video tutorial shows the surgical approach, cardiopulmonary bypass solutions, and sutureless valve deployment.


Author(s):  
Giuseppe Santarpino ◽  
Steffen Pfeiffer ◽  
Giovanni Concistrè ◽  
Theodor Fischlein

Objective There is an increase of old patients needing aortic valve surgery. Especially in this age group, a lot of new less-invasive strategies are proposed. Our goal was to study whether a sutureless aortic valve, which is implanted surgically after removal of the native valve, could be an alternative for a subgroup of patients. Methods The Sorin Perceval S is a biologic pericardial aortic valve assembled in a metal super elastic alloy stent and implanted in the aortic root without the need of suturing. As part of a premarketing multicenter study (Cavalier trial), 34 patients were screened for Perceval S implantation. All patients underwent cardiopulmonary bypass and mini-invasive approach (partial upper sternotomy). Results Fourteen patients were excluded due to standardized criteria. Twenty patients received a 21-mm valve (2 patients), 23-mm valve (6 patients), or 25-mm valve (12 patients). X-clamp time was 20.6 ± 7.6 minutes, and implantation time was 8.6 ± 3.1 minutes. Intra- and postoperative echocardiography showed no paravalvular leakage, low gradients (max 16.3 ± 5, mean 9.8 ± 4.2), and two patients with an intraprosthesis reflux (one patient with 1/4+, one patient with 2/4+). All patients were discharged without major in-hospital complications (intensive care unit stay 1.4 ± 0.5 days, hospital stay 7 ± 0.7 days). Conclusions The sutureless Perceval S aortic valve is hemodynamically excellent and a safe prosthesis in selected patients. Due to a simple and fast implantation technique, this valve could guarantee a shorter operation time in combination with a mini-invasive approach.


2018 ◽  
Vol 19 ◽  
pp. e44
Author(s):  
E. Mikus ◽  
M. Pagliaro ◽  
S. Calvi ◽  
M. Panzavolta ◽  
E. Ramoni ◽  
...  

2021 ◽  
pp. 152660282110025
Author(s):  
Nikolaos Konstantinou ◽  
Sven Peterss ◽  
Jan Stana ◽  
Barbara Rantner ◽  
Ramin Banafsche ◽  
...  

Purpose To present a novel technique to successfully cross a mechanical aortic valve prosthesis. Technique A 55-year-old female patient with genetically verified Marfan syndrome presented with a 5-cm anastomotic aneurysm of the proximal aortic arch after previous ascending aortic replacement due to a type A aortic dissection in 2007. The patient also underwent mechanical aortic valve replacement in 1991. A 3-stage hybrid repair was planned. The first 2 steps included debranching of the supra-aortic vessels. In the third procedure, a custom-made double branched endovascular stent-graft with a short 35-mm introducer tip was implanted. The mechanical valve was passed with the tip of the dilator on the lateral site of the leaflet, without destructing the valve and with only mild symptoms of aortic insufficiency, as one leaflet continued to work. This allowed the implantation of the stent-graft directly distally of the coronary arteries. Postoperative computed tomography angiography showed no endoleaks and patent coronary and supra-aortic vessels. Conclusion Passing a mechanical aortic valve prosthesis at the proper position is feasible and allows adequate endovascular treatment in complex arch anatomy. However, caution should be taken during positioning of the endovascular graft as the tip may potentially damage the valve prosthesis.


Author(s):  
Benyamin Rahmani ◽  
Hossein Ghanbari ◽  
Spyridon Tzamtzis ◽  
Gaetano Burriesci ◽  
Alexander M. Seifalian

Aortic valve replacement (AVR) is the second most common cardiac procedure after coronary artery bypass grafting, accounting for more than 200,000 transplantations annually worldwide [1]. Currently available mechanical and bioprosthetic heart valve replacements are not ideal as they are associated with relevant complications. The tri-leaflet polymeric heart valves (PHVs) have been widely investigated as possible alternative to these substitutes. However, the clinical application of PHVs has been limited by their suboptimal design and poor durability of available polymeric materials. This study presents a new concept of surgical aortic valve using a novel nanocomposite polymer.


2010 ◽  
Vol 106 (5) ◽  
pp. 707-712 ◽  
Author(s):  
Matthieu Godin ◽  
Helene Eltchaninoff ◽  
Akira Furuta ◽  
Christophe Tron ◽  
Frederic Anselme ◽  
...  

2017 ◽  
Vol 42 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Florian Hellmeier ◽  
Sarah Nordmeyer ◽  
Pavlo Yevtushenko ◽  
Jan Bruening ◽  
Felix Berger ◽  
...  

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