Are Sutureless Aortic Valves Suitable for Severe High-Risk Patients Suffering from Active Infective Aortic Valve Endocarditis?

被引:17
作者
Weymann, Alexander [1 ]
Konertz, Johanna [1 ]
Laule, Michael [2 ]
Stangl, Karl [2 ]
Dohmen, Pascal M. [1 ,3 ]
机构
[1] Carl von Ossietzky Univ Oldenburg, Univ Hosp Oldenburg, European Med Sch Oldenburg Groningen, Dept Cardiac Surg, Oldenburg, Germany
[2] Med Univ Berlin, Charite Hosp, Dept Cardiol & Angiol, Berlin, Germany
[3] Free State Univ, Dept Cardiothorac Surg, Fac Hlth Sci, Bloemfontein, South Africa
来源
MEDICAL SCIENCE MONITOR | 2017年 / 23卷
关键词
Cardiac Surgical Procedures; Endocarditis; Bacterial; Heart Valve Prosthesis Implantation; RAPID DEPLOYMENT; ROOT ABSCESS; REPLACEMENT; IMPLANTATION; SURGERY; EXPERIENCE; MANAGEMENT; DISEASE; PROFILE; TRIAL;
D O I
10.12659/MSM.902785
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Sutureless aortic valves were introduced to facilitate minimally invasive aortic valve surgery. Since sutureless aortic valves are a feasible procedure, we evaluated if any benefits could be identified in severe high-risk patients with active infective endocarditis of the aortic valve. Material/Methods: Between April 2014 and April 2015, a total of 42 patients received a sutureless Perceval (R) aortic valve (Sorin Biomedica Cardio Srl, Saluggia, Italy) for different indications. Nine of these patients (median age 71 years, range 47-83 years) suffered from active infective endocarditis, including four patients with prosthetic aortic valve endocarditis. Five patients underwent prior cardiac surgery, including transcatheter aortic valve implantation (TAVI). The median EuroSCORE II was 29.5% (range 16.8-87.7%). Post-operatively, data regarding mortality, operative results, and early operative morbidity were collected. Results: There were no cases of 30-day mortality. Four patients needed abscess closure with pericardium. Three patients underwent left atrial appendix closure: one left ventricular thrombectomy, one bypass grafting, and one arch replacement. Median aortic cross-clamp and cardiopulmonary bypass time was 35 minutes (range 26-88 minutes) and 52 minutes (range 40-133 minutes), respectively. The median intubation time was 14 hours (range 1-9 hours). In these high-risk patients, no postoperative morbidity was found except for one re-intubation due to extensive delirium and one re-exploration. No pacemaker implantation was needed. Echocardiographic evaluation showed no central or para-valvular regurgitation, and a median discharge mean gradient of 5.5 mm Hg (range 2.5-10.0 mm Hg). Conclusions: Sutureless aortic valve replacement in very high-risk patients suffering from active infection endocarditis seems to be an option with limited morbidity and appropriate echocardiographic results, however, further studies are needed.
引用
收藏
页码:2782 / 2787
页数:6
相关论文
共 37 条
[1]   Infective Endocarditis After Transcatheter Aortic Valve Implantation Results From a Large Multicenter Registry [J].
Amat-Santos, Ignacio J. ;
Messika-Zeitoun, David ;
Eltchanino, Helene ;
Kapadia, Samir ;
Lerakis, Stamatios ;
Cheema, Asim N. ;
Gutierrez-Ibanes, Enrique ;
Munoz-Garcia, Antonio J. ;
Pan, Manuel ;
Webb, John G. ;
Herrmann, Howard C. ;
Kodali, Susheel ;
Notnbela-Franco, Luis ;
Tamburino, Corrado ;
Jilaihawi, Hasan ;
Masson, Jean-Bernard ;
de Brito, Fabio Sandoli, Jr. ;
Ferreira, Maria Cristina ;
Lima, Valter Correa ;
Mangione, Jose Armando ;
Iung, Bernard ;
Vahanian, Alec ;
Durand, Eric ;
Tuzcu, E. Murat ;
Hayek, Salim S. ;
Angulo-Llanos, Rocio ;
Gomez-Doblas, Juan J. ;
Castillo, Juan Carlos ;
Dvir, Danny ;
Leon, Martin B. ;
Garcia, Eulogio ;
Cobiella, Javier ;
Vilacosta, Isidre ;
Barbanti, Marco ;
Makkar, Raj R. ;
Ribeiro, Henrique Barbosa ;
Urena, Marina ;
Dumont, Eric ;
Pibarot, Philippe ;
Lopez, Javier ;
San Roman, Alberto ;
Rodes-Cabau, Josep .
CIRCULATION, 2015, 131 (18) :1566-1574
[2]   Immediate outcome after sutureless versus transcatheter aortic valve replacement [J].
Biancari, Fausto ;
Barbanti, Marco ;
Santarpino, Giuseppe ;
Deste, Wanda ;
Tamburino, Corrado ;
Gulino, Simona ;
Imme, Sebastiano ;
Di Simone, Emanuela ;
Todaro, Denise ;
Pollari, Francesco ;
Fischlein, Theodor ;
Kasama, Keiichiro ;
Meuris, Bart ;
Dalen, Magnus ;
Sartipy, Ulrik ;
Svenarud, Peter ;
Lahtinen, Jarmo ;
Heikkinen, Jouni ;
Juvonen, Tatu ;
Gatti, Giuseppe ;
Pappalardo, Aniello ;
Mignosa, Carmelo ;
Rubino, Antonino S. .
HEART AND VESSELS, 2016, 31 (03) :427-433
[3]  
Borger Michael A, 2013, Multimed Man Cardiothorac Surg, V2013, pmmt011, DOI 10.1093/mmcts/mmt011
[4]   A Randomized Multicenter Trial of Minimally Invasive Rapid Deployment Versus Conventional Full Sternotomy Aortic Valve Replacement [J].
Borger, Michael A. ;
Moustafine, Vadim ;
Conradi, Lenard ;
Knosalla, Christoph ;
Richter, Markus ;
Merk, Denis R. ;
Doenst, Torsten ;
Hammerschmidt, Robert ;
Treede, Hendrik ;
Dohmen, Pascal ;
Strauch, Justus T. .
ANNALS OF THORACIC SURGERY, 2015, 99 (01) :17-24
[5]   Current trends in aortic valve replacement: development of the rapid deployment EDWARDS INTUITY valve system [J].
Borger, Michael A. ;
Dohmen, Pascal ;
Misfeld, Martin ;
Mohr, Friedrich W. .
EXPERT REVIEW OF MEDICAL DEVICES, 2013, 10 (04) :461-470
[6]   Association Between Surgical Indications, Operative Risk, and Clinical Outcome in Infective Endocarditis A Prospective Study From the International Collaboration on Endocarditis [J].
Chu, Vivian H. ;
Park, Lawrence P. ;
Athan, Eugene ;
Delahaye, Francois ;
Freiberger, Tomas ;
Lamas, Cristiane ;
Miro, Jose M. ;
Mudrick, Daniel W. ;
Strahilevitz, Jacob ;
Tribouilloy, Christophe ;
Durante-Mangoni, Emanuele ;
Pericas, Juan M. ;
Fernandez-Hidalgo, Nuria ;
Nacinovich, Francisco ;
Rizk, Hussien ;
Krajinovic, Vladimir ;
Giannitsioti, Efthymia ;
Hurley, John P. ;
Hannan, Margaret M. ;
Wang, Andrew .
CIRCULATION, 2015, 131 (02) :131-U46
[7]   Minimally invasive valve operations [J].
Cosgrove, DM ;
Sabik, JF ;
Navia, JL .
ANNALS OF THORACIC SURGERY, 1998, 65 (06) :1535-1538
[8]   Double valve replacement and reconstruction of the intervalvular fibrous body in patients with active infective endocarditis [J].
Davierwala, Piroze M. ;
Binner, Christian ;
Subramanian, Sreekumar ;
Luehr, Maximilian ;
Pfannmueller, Bettina ;
Etz, Christian ;
Dohmen, Pascal ;
Misfeld, Martin ;
Borger, Michael A. ;
Mohr, Friedrich W. .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2014, 45 (01) :146-152
[9]   Outcome of Aortic Valve Replacement for Active Infective Endocarditis in Patients on Chronic Hemodialysis [J].
Dohmen, Pascal M. ;
Binner, Christian ;
Mende, Meinhart ;
Bakhtiary, Farhad ;
Etz, Christian ;
Pfannmueller, Bettina ;
Davierwala, Piroze ;
Borger, Michael A. ;
Misfeld, Martin ;
Mohr, Friedrich W. .
ANNALS OF THORACIC SURGERY, 2015, 99 (02) :532-538
[10]   BENEFITS OF SUTURELESS AORTIC VALVES MAY NOT BE LIMITED TO REDUCED CROSSCLAMP TIME [J].
Dohmen, Pascal M. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2015, 149 (01) :395-395