Marco Vola1, Salvatore Campisi2, Antoine Gerbay3, Jean-François Fuzellier2, Iness Ayari2, Jean-Pierre Favre2, Michael Faure4, Jerôme Morel4, Amedeo Anselmi2. 1. Cardiovascular Surgery Unit, University Hospital St-Etienne, St-Priest en Jarez, France. Electronic address: marco.vola@univ-st-etienne.fr. 2. Cardiovascular Surgery Unit, University Hospital St-Etienne, St-Priest en Jarez, France. 3. Cardiology Unit, University Hospital St-Etienne, St-Priest en Jarez, France. 4. Anesthesiology and Reanimation Department, University Hospital St-Etienne, St-Priest en Jarez, France.
Abstract
BACKGROUND: Recently, sutureless aortic bioprostheses have been increasingly adopted to facilitate minimally invasive aortic valve replacement. We aimed at evaluating the impact of the transition from conventional bioprostheses to the routine use of the 3f Enable prosthesis (Medtronic ATS Medical, Minneapolis, MN) for aortic valve replacement through ministernotomy. METHODS: Between November 2009 and November 2012, 83 consecutive minimally invasive aortic valve replacement procedures were performed in our institution by the same surgeon through an upper T-shaped ministernotomy. The earliest 42 patients (group A) received a conventional bioprosthesis, and the later 41 patients (group B) received the sutureless 3f Enable valve. Aortic clamping and cardiopulmonary bypass times, early outcomes, and valve hemodynamics were compared. RESULTS: There was no statistical intergroup difference in baseline characteristics. In-hospital mortality was 1% (a single nonvalve-related death). Average aortic clamping times in group A and group B were, respectively, 85 ± 17 and 47 ± 11 minutes (p < 0.0001); the cardiopulmonary bypass time was 108 ± 21 and 69 ± 15 minutes, respectively (p < 0.0001). There were three paravalvular leakages in group A (grade I) and four in group B (two grade I, and two grade II); three pacemaker implantations occurred in group B (p = 0.07); mean transvalvular gradient at discharge was 16.9 ± 9.1 mm Hg in group A and 11.4 ± 4.3 mm Hg in group B (p = 0.0007). During follow-up (average 25.5 ± 12.9 months), one structural valve deterioration was registered in group A, and was treated with a valve-in-valve procedure. CONCLUSIONS: In our initial experience, the sutureless 3f Enable technology significantly reduced the clamping and cardiopulmonary bypass times, as well as the mean transvalvular gradient in aortic valve replacement through ministernotomy.
BACKGROUND: Recently, sutureless aortic bioprostheses have been increasingly adopted to facilitate minimally invasive aortic valve replacement. We aimed at evaluating the impact of the transition from conventional bioprostheses to the routine use of the 3f Enable prosthesis (Medtronic ATS Medical, Minneapolis, MN) for aortic valve replacement through ministernotomy. METHODS: Between November 2009 and November 2012, 83 consecutive minimally invasive aortic valve replacement procedures were performed in our institution by the same surgeon through an upper T-shaped ministernotomy. The earliest 42 patients (group A) received a conventional bioprosthesis, and the later 41 patients (group B) received the sutureless 3f Enable valve. Aortic clamping and cardiopulmonary bypass times, early outcomes, and valve hemodynamics were compared. RESULTS: There was no statistical intergroup difference in baseline characteristics. In-hospital mortality was 1% (a single nonvalve-related death). Average aortic clamping times in group A and group B were, respectively, 85 ± 17 and 47 ± 11 minutes (p < 0.0001); the cardiopulmonary bypass time was 108 ± 21 and 69 ± 15 minutes, respectively (p < 0.0001). There were three paravalvular leakages in group A (grade I) and four in group B (two grade I, and two grade II); three pacemaker implantations occurred in group B (p = 0.07); mean transvalvular gradient at discharge was 16.9 ± 9.1 mm Hg in group A and 11.4 ± 4.3 mm Hg in group B (p = 0.0007). During follow-up (average 25.5 ± 12.9 months), one structural valve deterioration was registered in group A, and was treated with a valve-in-valve procedure. CONCLUSIONS: In our initial experience, the sutureless 3f Enable technology significantly reduced the clamping and cardiopulmonary bypass times, as well as the mean transvalvular gradient in aortic valve replacement through ministernotomy.
Authors: Kei Woldendorp; Mathew P Doyle; Paul G Bannon; Martin Misfeld; Tristan D Yan; Giuseppe Santarpino; Paolo Berretta; Marco Di Eusanio; Bart Meuris; Alfredo Giuseppe Cerillo; Pierluigi Stefàno; Niccolò Marchionni; Jacqueline K Olive; Tom C Nguyen; Marco Solinas; Giacomo Bianchi Journal: Ann Cardiothorac Surg Date: 2020-09
Authors: Mohammad Yousuf Salmasi; Sruthi Ramaraju; Iqraa Haq; Ryan A B Mohamed; Taimoor Khan; Faruk Oezalp; George Asimakopoulos; Shahzad G Raja Journal: J Card Surg Date: 2022-01-14 Impact factor: 1.778