Sutureless Valve in Aortic Valve Reoperation: Results from an International Prospective Registry

2019 ◽  
Vol 3 (sup1) ◽  
pp. 118-118
Author(s):  
Mattia Glauber ◽  
William Kent ◽  
George Asimakopoulos ◽  
Giovanni Troise ◽  
Josep Maria Padrò ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Sutureless Valve

Minimally invasive redo aortic valve replacement with a sutureless valve implant

2021 ◽  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Valve Prosthesis ◽  
Mechanical Prosthesis ◽  
Invasive Approach ◽  
Replacement Procedure ◽  
Aortic Valve Prosthesis ◽  
Sutureless Valve

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.

Sutureless Valve Replacement Through a Right Anterior Mini-thoracotomy in Elderly Patients With Stenotic Bicuspid Aortic Valve

2019 ◽  
Vol 31 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Mustafa Serkan Durdu ◽  
Fatih Gumus ◽  
Evren Ozcinar ◽  
Mehmet Cakici ◽  
Onat Bermede ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Sutureless Valve ◽  
Mini Thoracotomy

Proof of Concept of an Endoscopic Sutureless Valve Sizer

2016 ◽  
Vol 11 (5) ◽  
pp. 337-341 ◽  
Author(s):  
Marco Vola ◽  
Juan Pablo Maureira ◽  
Vito Giovanni Ruggieri ◽  
Jean-François Fuzellier ◽  
Salvatore Campisi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Early Stage ◽  
Ascending Aorta ◽  
Aortic Annulus ◽  
Laboratory Evaluation ◽  
Proof Of Concept ◽  
Valve Size ◽  
Sutureless Valve ◽  
Selection Of

Objective In this paper, we present an endoscopic expandable sizer conceived to allow thoracoscopic aortic valve replacement with a sutureless prosthesis using a dynamic sizing of the aortic annulus. Methods Ten aortic torsos were prepared using a five-trocar thoracoscopic setting. Once the aortotomy was performed and the aortic valve leaflets removed, the technical feasibility of the endoscopic sizing (introduction into the trocar, expansion into the aortic annulus, determination of the valve size, and retraction) with the device was assessed. In case of successful thoracoscopic sizing, endoscopic implantation of a sutureless valve (five LivaNova Perceval prosthesis and five Medtronic 3f Enable bioprosthesis) was performed. Before ascending aorta closure, we assessed the appropriate sealing of the bioprosthesis in the native annulus with camera visualization and a nerve hook inspection. Results All the 10 endoscopic sizings were technically feasible. The scheduled aortic sutureless valve implantations were successfully performed. In all cases, fitting and placement of the sutureless bio-prosthesis in the flaccid heart was satisfactory, with no paraprosthetic leakage detectable by the nerve hook. Conclusions The use of the endoscopic expandable sizer is technically possible. In this early-stage test in the flaccid heart, selection of the valve size was satisfactory during thoracoscopic sutureless aortic bioprosthesis implantation. Further laboratory evaluation with fluid dynamics (aortic root pressurization) will be performed before a clinical study is started.

Advantages of Sutureless Aortic Valve in a Patient with Unsuspected Pheochromocytoma

2010 ◽  
Vol 5 (4) ◽  
pp. 306-308 ◽  
Author(s):  
Jia-Lin Soon ◽  
Fiona A. M. Gibson ◽  
Shirley Janas ◽  
Ravi Pillai
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
General Anesthesia ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Sutureless Valve ◽  
Intraoperative Hypertension ◽  
Short Implant

We describe a 60-year-old man who underwent elective aortic valve replacement and concurrent single graft coronary artery bypass surgery with acute intraoperative hypertension. The early suspicion of a pheochromocytoma and immediate aggressive pharmacologic intervention are discussed. Expeditious surgery contributed to the good outcome. It is possible that the short implant time of the sutureless valve may have been beneficial, but this is speculative. The management of an undiagnosed pheochromocytoma presenting during general anesthesia is reviewed.

Sutureless Aortic Valve Replacement via Partial Sternotomy

2010 ◽  
Vol 5 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Sven Martens ◽  
Andreas Zierer ◽  
Anja Ploss ◽  
Sami Sirat ◽  
Aleksandra Miskovic ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Minimal Invasive ◽  
Partial Sternotomy ◽  
Sutureless Valve ◽  
Valve Implantation

Objective For elderly patients with symptomatic aortic valve stenosis, aortic valve replacement with tissue valves is still the treatment of choice. Stentless valves were introduced to clinical practice for better hemodynamic features as compared with stented tissue valves. However, the implantation is more complex and time demanding, especially in minimal invasive aortic valve replacement. We present our clinical data on 22 patients having received a sutureless ATS 3f Enable aortic bioprosthesis via partial upper sternotomy. Methods The procedure was performed using CPB with cardioplegic arrest. After resection of the stenotic aortic valve and debridement of the annulus, the valve was inserted and released. Mean age was 79 years, and mean logistic Euroscore was 13. Subvalvular myectomy was performed in two patients. Prosthetic valve sizes were 19 mm (n = 1), 21 mm (n = 7), 23 mm (n = 6), 25 mm (n = 6), and 27 mm (n = 2). Results Implantation of the valve required 10 ± 6 minutes. Cardiopulmonary bypass and aortic crossclamp time were 87 ± 16 and 55 ± 11 minutes, respectively. Early mortality (<90 days) was 9% (2 patients). No paravalvular leakage was detected intraoperatively or in follow-up echocardiography. The mean transvalvular gradients were 9 ± 6 mm Hg at discharge and 8 ± 2 mm Hg at 1-year follow-up. Conclusions Sutureless valve implantation via partial sternotomy is feasible and safe with the ATS 3f Enable bioprosthesis. Reduction of cardiopulmonary bypass and aortic crossclamp time seems possible with increasing experience. Hemodynamic data are very promising with low gradients at discharge and after 12 month. Sutureless valve implantation via minimal invasive access may be an alternative treatment option for elderly patients with high comorbidity.

scholarly journals Aortic Root Enlargement or Sutureless Valve Implantation?

2016 ◽  
Vol 4 (4) ◽  
pp. 742-743 ◽  
Author(s):  
Nikolaos G. Baikoussis ◽  
Panagiotis Dedeilias ◽  
Michalis Argiriou
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Root ◽  
Negative Impact ◽  
Term Survival ◽  
Old Patients ◽  
Sutureless Valve ◽  
Aortic Root Enlargement ◽  
Valve Implantation

Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM) post aortic valve replacement (AVR) is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR) and the transcatheter valve implantation (TAVI).

Rescue Balloon Aortic Valvuloplasty After Sutureless Aortic Valve Replacement for Severe Paravalvular Leak

2019 ◽  
Vol 14 (5) ◽  
pp. 476-479 ◽  
Author(s):  
Eiki Nagaoka ◽  
Keita Sato ◽  
Ali Hage ◽  
Rodrigo Bagur ◽  
Christopher Harle ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
New Technology ◽  
Balloon Valvuloplasty ◽  
Paravalvular Leak ◽  
Aortic Cross Clamp ◽  
Balloon Aortic Valvuloplasty ◽  
Sutureless Valve ◽  
The Right

Sutureless aortic valve replacement (AVR) is a wide-spreading new technology that provides short clamping time and excellent hemodynamic outcomes. However, among its possible complications is the risk of paravalvular leak. We present the case of a 63-year-old woman who underwent minimally invasive right mini-thoracotomy AVR) with Perceval S sutureless valve (LivaNova, London, UK). Intraoperative transesophageal echocardiography revealed severe paravalvular leak with stent distortion. Rescue balloon valvuloplasty was performed through the right femoral artery, and resulted in the resolution of the paravalvular leak. This case illustrates the utility and feasibility of balloon valvuloplasty in trouble-shooting sutureless aortic valve stent distortion, thus avoiding a repeat aortic cross-clamp and valve replacement.

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