scholarly journals Current Clinical Evidence on Rapid Deployment Aortic Valve Replacement: Sutureless Aortic Bioprostheses

2016 ◽  
Vol 11 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Glenn R. Barnhart ◽  
Malakh Lal Shrestha
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Western World ◽  
High Risk Population ◽  
Additional Tool ◽  
Age Related ◽  
Number Of Patients ◽  
Rapid Deployment

Aortic stenosis is the most common valvular heart disease in the Western world. It is caused primarily by age-related degeneration and progressive calcification typically detected in patients 65 years and older. In patients presenting with symptoms of heart failure, the average survival rate is only 2 years without appropriate treatment. Approximately one half of all patients die within the first 2 to 3 years of symptom onset. In addition, the age of the patients presenting for aortic valve replacement (AVR) is increased along with the demographic changes. The Society of Thoracic Surgeons (STS) database shows that the number of patients older than 80 years has increased from 12% to 24% during the past 20 years. At the same time, the percentage of candidates requiring AVR as well as concomitant coronary bypass surgery has increased from 5% to 25%. Surgical AVR continues to be the criterion standard for treatment of aortic stenosis, improving survival and quality of life. Recent advances in prosthetic valve technology, such as transcatheter AVR, have expanded the indication for AVR to the extreme high-risk population, and the most recent surgical innovation, rapid deployment AVR, provides an additional tool to the surgeons’ armamentarium.

scholarly journals Exercise Hemodynamics and Quality of Life after Aortic Valve Replacement for Aortic Stenosis in the Elderly Using the Hancock II Bioprosthesis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Theodore Long ◽  
Becky M. Lopez ◽  
Christopher Berberian ◽  
Mark J. Cunningham ◽  
Vaughn A. Starnes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Functional Classification ◽  
Age Related ◽  
Sf 36

Background and Aim. While aortic valve replacement for aortic stenosis can be performed safely in elderly patients, there is a need for hemodynamic and quality of life evaluation to determine the value of aortic valve replacement in older patients who may have age-related activity limitation.Materials and Methods. We conducted a prospective evaluation of patients who underwent aortic valve replacement for aortic stenosis with the Hancock II porcine bioprosthesis. All patients underwent transthoracic echocardiography (TTE) and completed the RAND 36-Item Health Survey (SF-36) preoperatively and six months postoperatively.Results. From 2004 to 2007, 33 patients were enrolled with an average age of 75.3 ± 5.3 years (24 men and 9 women). Preoperatively, 27/33 (82%) were New York Heart Association (NYHA) Functional Classification 3, and postoperatively 27/33 (82%) were NYHA Functional Classification 1. Patients had a mean predicted maximumVO2(mL/kg/min) of 19.5 ± 4.3 and an actual maxVO2of 15.5 ± 3.9, which was 80% of the predictedVO2. Patients were found to have significant improvements (P≤0.01) in six of the nine SF-36 health parameters.Conclusions. In our sample of elderly patients with aortic stenosis, replacing the aortic valve with a Hancock II bioprosthesis resulted in improved hemodynamics and quality of life.

scholarly journals Rapid-deployment aortic valve replacement for severe aortic stenosis: 1-year outcomes in 150 patients†

2017 ◽  
Vol 25 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Alexis Theron ◽  
Eleonore Ravis ◽  
Dominique Grisoli ◽  
Nicolas Jaussaud ◽  
Pierre Morera ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Rapid Deployment

scholarly journals Evaluation and Management of Aortic Stenosis in Chronic Kidney Disease: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Gautam R. Shroff ◽  
Sripal Bangalore ◽  
Nicole M. Bhave ◽  
Tara I. Chang ◽  
Santiago Garcia ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Clinical Decision Making ◽  
Imaging Techniques ◽  
High Risk Population ◽  
Prognostic Information

Aortic stenosis with concomitant chronic kidney disease (CKD) represents a clinical challenge. Aortic stenosis is more prevalent and progresses more rapidly and unpredictably in CKD, and the presence of CKD is associated with worse short-term and long-term outcomes after aortic valve replacement. Because patients with advanced CKD and end-stage kidney disease have been excluded from randomized trials, clinicians need to make complex management decisions in this population that are based on retrospective and observational evidence. This statement summarizes the epidemiological and pathophysiological characteristics of aortic stenosis in the context of CKD, evaluates the nuances and prognostic information provided by noninvasive cardiovascular imaging with echocardiography and advanced imaging techniques, and outlines the special risks in this population. Furthermore, this statement provides a critical review of the existing literature pertaining to clinical outcomes of surgical versus transcatheter aortic valve replacement in this high-risk population to help guide clinical decision making in the choice of aortic valve replacement and specific prosthesis. Finally, this statement provides an approach to the perioperative management of these patients, with special attention to a multidisciplinary heart-kidney collaborative team-based approach.

scholarly journals Sutureless bioprothesis in aortic valve surgery

2020 ◽  
Vol 98 (6) ◽  
pp. 440-448
Author(s):  
I. A. Borisov ◽  
V. V. Dalinin ◽  
V. B. Simonenko ◽  
A. A. Sergovencev ◽  
P. E. Kraynukov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Functional Class ◽  
Long Term Results ◽  
Number Of Patients

Objective: aortic valve replacement is a «gold standard» in the surgical treatment of aortic stenosis. At the same time, an increasing number of patients require combined surgical interventions in addition to aortic valve replacement. Currently, surgical mortality in 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 implantation requires careful analysis of the immediate and long-term results of their implantation and comparison to the results of standard methods of treatment. Material and methods. The study was designed as a prospective-retrospective study for evaluation of results of different types of biological prostheses use in case of isolated aortic valve stenosis and together with concomitant cardiac pathology. The study included patients over 65 years old with aortic stenosis, who underwent aortic valve replacement. The patients were divided into two groups. The comparison was carried out by the following criteria: intraoperative data, the number and nature of postoperative complications, survival, freedom from ischemic events and from reoperation, dynamics of transaortic gradient, hemodynamic characteristics for the entire evaluation period (5 years). Results. In the group of patients with implanted sutureless valves, there was a smaller number of postoperative complications, faster recovery, significantly lower mortality rates, higher freedom from valve-related complications in postoperative period.Conclusions. The use of sutureless prostheses is justified for the aortic valve replacement and is safer compared to standard valves, in the absence of contraindications. Surgical treatment of patients with aortic stenosis with the use of sutureless valves led to significant clinical improvement in most of them, both in the functional class and in the threshold of tolerance to physical activity. The level of typical valve replacement complications was significantly lower. Simplicity and reproducibility of the procedure, fast learning process can certainly contribute s to wider and more active implementation of this technology in clinical practice.

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