Early Outcomes of Pulmonary Valve Replacement With the Edwards Inspiris Resilia Pericardial Bioprosthesis.

IF 1.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Aditya Sengupta, Peter Pastuszko, Ali N Zaidi, Raghav A Murthy
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引用次数: 0

Abstract

Background: Controversy regarding the optimal pulmonary valve substitute remains, with no approved surgical valve for pulmonary valve replacement (PVR). Furthermore, unfavorable anatomy often precludes transcatheter PVR in patients with congenital heart disease. We therefore sought to evaluate the feasibility of the Edwards Inspiris pericardial aortic bioprosthesis in the pulmonary position in pediatric and adult patients requiring PVR.

Methods: Data from consecutive patients who underwent PVR from February 2019 to February 2021 at our institution were retrospectively reviewed. Postoperative adverse events included paravalvular or transvalvular leak, endocarditis, explant, thromboembolism, valve thrombosis, valve-related bleeding, hemolysis, and structural valve degeneration. Progression of valve gradients was assessed from discharge to 30 days and one year.

Results: Of 24 patients with median age of 26 years (interquartile range [IQR]: 17-33; range: 4-60 years), 22 (91.7%) patients had previously undergone tetralogy of Fallot repair and 2 (8.3%) patients had undergone double-outlet right ventricle repair in the neonatal period or infancy. All patients had at least mild right ventricular (RV) dilatation (median RV end-diastolic volume index 161.4, IQR: 152.3-183.5 mL/m2) and at least moderate pulmonary insufficiency (95.8%) or stenosis (8.3%). Median cardiopulmonary bypass and cross-clamp times were 71 (IQR: 63-101) min and 66 (IQR: 60-114) min, respectively. At a median postoperative follow-up of 2.5 years (IQR: 1.4-2.6; range: 1.0-3.0 years), there were no mortalities, valve-related reoperations, or adverse events. Postoperative valve gradients and the severity of pulmonary regurgitation did not change significantly over time.

Conclusions: At short-term follow-up, the bioprosthesis in this study demonstrated excellent safety and effectiveness for PVR. Further studies with longer follow-up are warranted.

使用 Edwards Inspiris Resilia 心包生物假体进行肺动脉瓣置换术的早期疗效。
背景:肺动脉瓣置换术(PVR)的最佳替代物仍存在争议,目前尚无经批准的手术瓣膜。此外,先天性心脏病患者由于解剖结构不佳,往往无法进行经导管肺动脉瓣置换术。因此,我们试图评估 Edwards Inspiris 心包主动脉生物假体在需要肺动脉瓣置换术的儿童和成人患者中肺动脉位置的可行性:回顾性审查了2019年2月至2021年2月期间在我院接受PVR的连续患者的数据。术后不良事件包括瓣旁或经瓣漏、心内膜炎、瓣膜剥离、血栓栓塞、瓣膜血栓形成、瓣膜相关出血、溶血和瓣膜结构变性。从出院到30天和一年期间,对瓣膜梯度的进展情况进行了评估:24名患者的中位年龄为26岁(四分位距[IQR]:17-33岁;范围:4-60岁),其中22名患者(91.7%)曾接受过法洛氏四联症修补术,2名患者(8.3%)曾在新生儿期或婴儿期接受过右心室双出口修补术。所有患者都至少有轻度右心室(RV)扩张(RV舒张末期容积指数中位数为161.4,IQR:152.3-183.5 mL/m2)和至少中度肺不张(95.8%)或肺动脉狭窄(8.3%)。心肺旁路和交叉钳夹的中位时间分别为 71(IQR:63-101)分钟和 66(IQR:60-114)分钟。术后中位随访 2.5 年(IQR:1.4-2.6;范围:1.0-3.0 年),无死亡、瓣膜相关再手术或不良事件发生。术后瓣膜梯度和肺动脉瓣反流的严重程度随时间变化不大:结论:在短期随访中,本研究中的生物瓣膜在治疗肺动脉瓣反流方面表现出了极佳的安全性和有效性。有必要进行更长时间的随访研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
11.10%
发文量
128
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