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.

scholarly journals 1269 Five Year Propensity Matched Outcomes of Minimally Invasive vs Conventional Isolated Aortic Valve Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Oo ◽  
A Khan ◽  
J Chan ◽  
H Vohra
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Rank Test ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Operative Outcomes ◽  
Significant Difference ◽  
Aortic Valve Prosthesis

Abstract Aim To analyse the early and mid-term outcomes of the patients undergoing conventional isolated aortic valve replacement (CAVR) versus minimally invasive isolated aortic valve replacement (MIAVR). Method This is a single centre retrospective study involving 653 patients who underwent isolated aortic valve replacement either via CAVR (n = 516) or MIAVR (n = 137) between August 2015 and March 2020. Using pre-operative characteristics, patients were propensity matched (PM) to produce 114 matched pairs. Assessment of peri-operative outcomes, early and mid-term survival and echocardiographic parameters was performed. Results PM analysis showed the larger sized aortic valve prosthesis were inserted in the MIAVR group (22.8±2.5mm) compared to CAVR group (22.0±2.2mm)(p = 0.010). CPB time was longer with MIAVR (94.4±19.5mins) compared to CAVR (83.1 + 33.3; p = 0.003). There were no differences in the early post-operative complications and mortality between the two groups. Follow-up echocardiographic data showed significant difference in mean aortic valve gradients between CAVR and MIAVR groups (17.3±8.2mmHg and13.0±5.1mmHg, respectively; p = 0.001). There was no significant difference between CAVR and MIAVR in the mid-term survival at 3 years. (log-rank test p = 0.314). Conclusions This study found that larger aortic valve sizes with lower mean gradients are being implanted in the MIAVR group. Despite the longer CPB time in the MIAVR group, there was no significant difference in the early complications, mortality, and mid-term survival between MIAVR and CAVR. Further studies will be required to analyse the long-term survival.

scholarly journals The first experience of implantation of the transcatheter aortal valve prosthesis “MedLab-KT”

2018 ◽  
pp. 50-57
Author(s):  
A. V. Bogachev-­Prokofiev ◽  
R. M. Sharifulin ◽  
D. D. Zubarev ◽  
A. M. Karaskov
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Valve Prosthesis ◽  
Routine Procedure ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Prosthesis ◽  
Aortal Valve ◽  
Transapical Access

Aim.Transcatheter aortic valve replacement in patients with high and extremely high risk has become a routine procedure in many cardiac surgery clinics. Until recently, there were no transcatheter prostheses produced within Russia. This article analyzes the results of applying the first domestic transcatheter aortic valve prosthesis MedLab­KT.Material and methods.In the period from June 2018 to October 2018, 7 operations of transcatheter aortic valve replacement were made using the MedLabKT prosthesis. In all cases, implantation was performed by transapical access.Results.We noted one death. In all cases, paraprosthetic regurgitation was not registrated or was not significant. There are no cases of dislocation of the prosthesis. There were no complications associated with access. In one case, implantation was complicated by myocardial infarction.Conclusion.The first experience of implantation demonstrated the efficacy and safety of using the MedLab­LT prosthesis for transcatheter aortic valve replacement. The analysis of long­term results is required.

scholarly journals Perceval S Sutureless Prosthesis in Aortic Valve Replacement

2019 ◽  
Vol 8 (1) ◽  
pp. 87-92
Author(s):  
V. V. Sokolov ◽  
A. I. Kovalyov ◽  
V. V. Vladimirov ◽  
I. V. Ivanov ◽  
N. M. Bikbova
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Valve Prosthesis ◽  
Pericardial Cavity ◽  
Results Of Treatment ◽  
Increased Risk ◽  
Complex Procedure ◽  
Aortic Valve Prosthesis ◽  
Made In

 BACKGROUND In 12–47% of patients, there is a need to repeat the aortic valve replacement due to various valve-related complications in the immediate and late postoperative period. The standard operation of repeated aortic valve replacement is a complex procedure and it is associated with an increased risk due to adhesions in the pericardial cavity, previously performed coronary bybass surgery, diffculties of excision of the previously implanted prosthesis, narrow fbrous aortic valve ring and aorta. In 2007, the sutureless Perceval S aortic valve bioprosthesis (Sorin Group, Italy) was introduced into clinical practice. One of the advantages of such a prosthesis is the convenience of its anatomical positioning during repeated operations and the absence of the need to fx the prosthesis with sutures. The aim of study was to summarize the experience of sutureless implantation of the aortic valve prosthesis during repeated replacement.MATERIAL AND METHODS We report the results of treatment in 3 patients with valve-associated complications, who underwent aortic valve repeated replacement with the Perceval S sutureless prosthesis.RESULTS There were no hospital mortality and paraprosthetic regurgitation in the repeated replacement of the aortic valve with the Perceval S sutureless prosthesis. Two patients required implantation of a permanent pacemaker due to the development of a complete atrioventricular block, which was not related to the model of the prosthesis used.CONCLUSION The use of aortic valve prosthesis in cardiac surgery, which does not require fxation with sutures, allows non-standard decisions to be made in the surgical treatment of patients with various complications of previously performed aortic valve replacement and provides good immediate results if repeated replacement is necessary.

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