Original Experience of Transaortic Approach in Bivalve Replacement
Background. Combined valve lesions affect more than one valve, which may hamper a correct estimation of the individual valve severity. The study aimed to assess the outcome of transaortic mitral valve replacement (TAMVR) in a bivalve replacement procedure.Materials and methods. A retrospective study...
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Bashkir State Medical University
2020-12-01
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| Series: | Креативная хирургия и онкология |
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| Online Access: | https://www.surgonco.ru/jour/article/view/529 |
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| author | I. I. Chernov S. T. Enginoev D. A. Kondratiev A. A. Ziankou D. G. Tarasov |
| author_facet | I. I. Chernov S. T. Enginoev D. A. Kondratiev A. A. Ziankou D. G. Tarasov |
| author_sort | I. I. Chernov |
| collection | DOAJ |
| description | Background. Combined valve lesions affect more than one valve, which may hamper a correct estimation of the individual valve severity. The study aimed to assess the outcome of transaortic mitral valve replacement (TAMVR) in a bivalve replacement procedure.Materials and methods. A retrospective study was conducted with 19 patients having TAMVR during bivalve replacement. The mean patient age was 58 ± 8.6 years, including 10 male patients. Diabetes mellitus was diagnosed in 3 patients, atrial fibrillation — in 14, coronary heart disease — in 2, chronic obstructive pulmonary disease — in 2, stroke in history — in 1, chronic heart failure stage 3–4 (NYHA) — in 19 patients. Infectious endocarditis as the disease aetiology was found in 4 patients. Two patients had previous heart surgery. Echocardiography: mean left ventricular ejection fraction 55 ± 7.3 %, mean pulmonary artery pressure 47 ± 13.7 mm Hg, median aortic valve fibrous ring diameter 23 (21–25) mm.Results and discussion. Mechanical replacement was performed in 12 cases. Median surgery time was 160 (150–185) min, median myocardial ischaemia (MI) time — 67 ± 9.7 min and artificial circulation (AC) time — 87 ± 12.5 min. Resternotomy for bleeding was performed in 2 patients, with median postoperative blood loss 300 (212–587) mL. Early postoperative delirium developed in 4 patients, acute renal failure requiring haemodialysis — in 1 patient. Stroke, perioperative myocardial damage and conduction disorder requiring pacemaker implantation not observed in postoperative period. Median artificial lung ventilation time (ALV) was 9.5 (6–15) h, ≥24 h — in two cases. One lethal early postoperative case was registered.Conclusion. TAMVR in a bivalve replacement setting is a safe technique with short AC, MI and surgery times and can be recommended in patients with a wide aortic valve fibrous ring. |
| format | Article |
| id | doaj-art-db5bb96fddeb4ed7bd0fecc1770812d5 |
| institution | Matheson Library |
| issn | 2076-3093 2307-0501 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | Bashkir State Medical University |
| record_format | Article |
| series | Креативная хирургия и онкология |
| spelling | doaj-art-db5bb96fddeb4ed7bd0fecc1770812d52025-08-03T19:48:54ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012020-12-0110428128610.24060/2076-3093-2020-10-4-281-286400Original Experience of Transaortic Approach in Bivalve ReplacementI. I. Chernov0S. T. Enginoev1D. A. Kondratiev2A. A. Ziankou3D. G. Tarasov4Federal Centre for Cardiovascular SurgeryFederal Centre for Cardiovascular Surgery; Astrakhan State Medical UniversityFederal Centre for Cardiovascular SurgeryFederal Centre for Cardiovascular SurgeryFederal Centre for Cardiovascular SurgeryBackground. Combined valve lesions affect more than one valve, which may hamper a correct estimation of the individual valve severity. The study aimed to assess the outcome of transaortic mitral valve replacement (TAMVR) in a bivalve replacement procedure.Materials and methods. A retrospective study was conducted with 19 patients having TAMVR during bivalve replacement. The mean patient age was 58 ± 8.6 years, including 10 male patients. Diabetes mellitus was diagnosed in 3 patients, atrial fibrillation — in 14, coronary heart disease — in 2, chronic obstructive pulmonary disease — in 2, stroke in history — in 1, chronic heart failure stage 3–4 (NYHA) — in 19 patients. Infectious endocarditis as the disease aetiology was found in 4 patients. Two patients had previous heart surgery. Echocardiography: mean left ventricular ejection fraction 55 ± 7.3 %, mean pulmonary artery pressure 47 ± 13.7 mm Hg, median aortic valve fibrous ring diameter 23 (21–25) mm.Results and discussion. Mechanical replacement was performed in 12 cases. Median surgery time was 160 (150–185) min, median myocardial ischaemia (MI) time — 67 ± 9.7 min and artificial circulation (AC) time — 87 ± 12.5 min. Resternotomy for bleeding was performed in 2 patients, with median postoperative blood loss 300 (212–587) mL. Early postoperative delirium developed in 4 patients, acute renal failure requiring haemodialysis — in 1 patient. Stroke, perioperative myocardial damage and conduction disorder requiring pacemaker implantation not observed in postoperative period. Median artificial lung ventilation time (ALV) was 9.5 (6–15) h, ≥24 h — in two cases. One lethal early postoperative case was registered.Conclusion. TAMVR in a bivalve replacement setting is a safe technique with short AC, MI and surgery times and can be recommended in patients with a wide aortic valve fibrous ring.https://www.surgonco.ru/jour/article/view/529cardiac valvesvalve replacementacquired heart diseasetransaortic approachaortic stenosisaortic regurgitation |
| spellingShingle | I. I. Chernov S. T. Enginoev D. A. Kondratiev A. A. Ziankou D. G. Tarasov Original Experience of Transaortic Approach in Bivalve Replacement Креативная хирургия и онкология cardiac valves valve replacement acquired heart disease transaortic approach aortic stenosis aortic regurgitation |
| title | Original Experience of Transaortic Approach in Bivalve Replacement |
| title_full | Original Experience of Transaortic Approach in Bivalve Replacement |
| title_fullStr | Original Experience of Transaortic Approach in Bivalve Replacement |
| title_full_unstemmed | Original Experience of Transaortic Approach in Bivalve Replacement |
| title_short | Original Experience of Transaortic Approach in Bivalve Replacement |
| title_sort | original experience of transaortic approach in bivalve replacement |
| topic | cardiac valves valve replacement acquired heart disease transaortic approach aortic stenosis aortic regurgitation |
| url | https://www.surgonco.ru/jour/article/view/529 |
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