Interventional versus Surgical Treatment of Degenerated Freestyle Prosthesis.

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Thoracic and Cardiovascular Surgeon Pub Date : 2024-04-01 Epub Date: 2023-03-01 DOI:10.1055/s-0043-1763286

Denis Fedorov, Robert Bauernschmitt, Jean-Pilippe Grunebaum, Stefan Bauer, Ralf Sodian, Eberhard von Hodenberg

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引用次数: 0

Abstract

Background: Bioprosthetic stentless aortic valves may degenerate over time and will require replacement. This study aimed to evaluate early- and mid-term outcomes after isolated surgical redo aortic valve replacement (redo-SAVR) and transcatheter valve-in-valve implantation (TAVI-VIV) for degenerated stentless Freestyle bioprostheses.

Methods: We reviewed records of 56 patients at a single center. Overall, 37 patients (66.1%) received TAVI-VIV and 19 (33.9%) received redo-SAVR.

Results: Thirty-day survival was similar in both groups (100%). One-year survival was comparable between groups (97.3% in TAVI-VIV and 100% in redo-SAVR, p = 1.0). The difference in mid-term survival after adjusting for age and EuroScore II was not significant (p = 0.41). The incidence of pacemaker implantation after TAVI-VIV was higher than after redo-SAVR (19.4% vs. 0%, p = 0.08).

Conclusion: The 30-day and 1-year survival rates after both procedures were outstanding, irrespective of baseline characteristics. Isolated redo-SAVR should be favored in young patients, as the pacemaker implantation rate is lower. TAVI-VIV for degenerated Freestyle prosthesis can be a method of choice in elderly patients and those with high operative risk.

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介入治疗与手术治疗退化的自由式假体。

背景：生物人工无支架主动脉瓣可能会随着时间的推移而退化，需要更换。本研究旨在评估对退化的无支架 Freestyle 生物主动脉瓣进行孤立手术重做主动脉瓣置换术（redo-SAVR）和经导管瓣膜植入术（TAVI-VIV）后的早期和中期疗效：我们回顾了一个中心 56 名患者的记录。37名患者（66.1%）接受了TAVI-VIV，19名患者（33.9%）接受了重做-SAVR：结果：两组患者的 30 天存活率相似（100%）。两组的一年生存率相当（TAVI-VIV 为 97.3%，重做-SAVR 为 100%，P = 1.0）。调整年龄和欧洲评分 II 后，两组的中期存活率差异不大（p = 0.41）。TAVI-VIV术后起搏器植入发生率高于重做-SAVR术后（19.4%对0%，P = 0.08）：结论：无论基线特征如何，两种手术后的30天和1年生存率都很高。结论：无论基线特征如何，两种手术后的30天和1年存活率都很高。年轻患者应首选孤立重做SAVR，因为起搏器植入率较低。TAVI-VIV治疗退化的Freestyle假体可作为老年患者和高手术风险患者的首选方法。

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

Thoracic and Cardiovascular Surgeon 医学-呼吸系统

CiteScore

3.40

自引率

6.70%

发文量

365

审稿时长

3 months

期刊介绍： The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.