Aortic valve replacement using a polytetrafluoroethylene leaflet valve in patients with a history of the Bentall–De Bono procedure: a case series

Q4 Medicine

Patologiya krovoobrashcheniya i kardiokhirurgiya Pub Date : 2023-03-30 DOI:10.21688/1681-3472-2023-1-54-59

V. Bazylev, A. B. Voevodin, I. D. Potopalskiy, V. A. Karnakhin, M. Patel, A. A. Kuznetsova

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Abstract

Objective: To analyze outcomes of 4 transcatheter aortic valve replacements using a polytetrafluoroethylene leaflet valve in patients with a history of the Bentall–De Bono procedure.Methods: We retrospectively analyzed a series of 4 cases. From February 2019 to March 2022 in Federal Center for Cardiovascular Surgery (Penza, Russia), patients with a history of the Bentall–De Bono procedure underwent transaortic aortic valve implantation of the MedLAB-CT balloon-expandable valve under cardiopulmonary bypass and cardioplegia. Valve No. 25 was implanted in 3 patients, and 1 patient received valve No. 23.Results: According to echocardiography, valve hemodynamic performance improved in the postoperative period: mean and peak pressure gradients were 11.5 and 24 mm Hg, respectively; the median value of effective orifice area was 1.9 cm2, while mitral regurgitation in all cases did not exceed grade 1. Median cardiopulmonary bypass and myocardial ischemia times were 59 and 31 minutes, respectively. There was no immediate and remote mortality. No complications were reported in the postoperative period.Conclusion: The proposed replacement of the valved conduit’s compromised part after the Bentall–De Bono procedure can significantly reduce the extent of surgery, cardiopulmonary bypass and myocardial ischemia times, as well as simplify the procedure. Received 1 December 2022. Revised 10 February 2023. Accepted 16 February 2023. Informed consent: The patient’s informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interests: The authors declare no conflict of interest. Contribution of the authorsLiterature review: V.A. Karnakhin, I.D. PotopalskiyDrafting the article: V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. KarnakhinCritical revision of the article: A.A. Kuznetsova, M.P. PatelSurgical treatment: V.V. Bazylev, A.B. VoevodinFinal approval of the version to be published: V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. Karnakhin, M.P. Patel, A.A. Kuznetsova

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有Bentall-De Bono手术史的患者使用聚四氟乙烯小叶瓣膜置换主动脉瓣:病例系列

目的:分析有本特尔-德博诺手术史的4例经导管主动脉瓣置换术的结果。方法:对4例患者进行回顾性分析。2019年2月至2022年3月，在俄罗斯奔萨联邦心血管外科中心(Federal Center for Cardiovascular Surgery, Penza, Russia)，有Bentall-De Bono手术史的患者在体外循环和心脏停跳下接受了MedLAB-CT球囊扩张瓣膜经主动脉瓣植入术。25号瓣膜植入3例，23号瓣膜植入1例。结果:超声心动图显示，术后瓣膜血流动力学性能有所改善:平均压力梯度11.5 mm Hg，峰值压力梯度24 mm Hg;有效孔面积中位数为1.9 cm2，所有病例二尖瓣返流均未超过1级。中位体外循环时间59分钟，心肌缺血时间31分钟。没有立即死亡和长期死亡。术后无并发症发生。结论:本特尔-德博诺手术后瓣膜导管受损部分的置换可显著减少手术面积、体外循环及心肌缺血次数，简化手术流程。收到2022年12月1日。2023年2月10日修订。2023年2月16日接受。知情同意:已取得患者知情同意将病历用于医疗目的。经费来源:本研究未获得赞助。利益冲突:作者声明无利益冲突。作者贡献文献综述:V.V. Karnakhin, I.D. Potopalskiy文章起草:V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. karnakhin文章关键修改:A.A. Kuznetsova, M.P. Patel手术治疗:V.V. Bazylev, A.B. Voevodin最终批准出版版本:V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. Karnakhin, M.P. Patel, A.A. Kuznetsova

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