Perceval 无缝线生物人工主动脉瓣:外科瓣膜技术的发展。

IF 1.6 Q2 SURGERY
Nicholas M Fialka, Ryaan El-Andari, Shaohua Wang, Aleksander Dokollari, William D T Kent, Ali Fatehi Hassanabad
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引用次数: 0

摘要

目的:主动脉瓣狭窄的手术治疗不断发展,无缝线主动脉瓣置换术(SUAVR)是一项新兴技术。Perceval S(Corcym,英国伦敦)是目前市场上唯一真正的无缝合瓣膜,本综述旨在分析目前有关 Perceval S 的文献,重点关注瓣膜的设计和部署以及该技术在具有挑战性的病理学中的应用,评估临床结果,包括与经导管主动脉瓣置换术(TAVR)的比较:方法:3 位作者在 PubMed 和 MEDLINE 上检索了从开始到 2023 年 5 月 19 日的 SUAVR 分析研究:结果:SUAVR有利于微创手术,为主动脉瓣环较小的患者提供了一种替代策略。对于需要复杂手术的患者来说,它还具有节省时间的优势。SUAVR 的长期发病率、死亡率、耐久性和血液动力学功能都非常出色。与传统手术 AVR(SAVR)相比,SUAVR 术后植入起搏器的风险更大;不过,用户经验的增加和植入技术的改进有助于降低这一结果。SUAVR 的发病率和死亡率与快速部署 AVR 相似。中期结果优于 TAVR;但是,最终还需要对所有这些比较结果进行进一步的深入研究:结论:SUAVR 弥补了 SAVR 和 TAVR 之间的技术差距。这项令人振奋的技术的应用无疑将在未来几年内不断增长,在此期间,进一步的研究对于优化术前规划、瓣膜部署和再介入策略至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology.

Objective: The surgical treatment of aortic stenosis continues to evolve, and sutureless aortic valve replacement (SUAVR) is an emerging technology. With the Perceval S (Corcym, London, UK) as the only true sutureless valve on the market, the objective of this review is to analyze the current literature on Perceval S. Focusing on valve design and deployment as well as applications of the technology for challenging pathology, clinical outcomes are assessed, including a comparison with transcatheter AVR (TAVR).

Methods: PubMed and MEDLINE were searched by 3 authors for studies analyzing SUAVR from inception to May 19, 2023.

Results: SUAVR facilitates minimally invasive surgery and offers an alternative strategy for patients with small aortic annuli. It also has a time-saving advantage for patients who require complex operations. SUAVR results in excellent long-term morbidity, mortality, durability, and hemodynamic function. In comparison with conventional surgical AVR (SAVR), SUAVR does have a greater risk of postoperative pacemaker implantation; however, increasing user experience and refinements in implantation technique have contributed to reductions in this outcome. SUAVR results in morbidity and mortality that is similar to rapid-deployment AVR. Midterm outcomes are superior to TAVR; however, further robust investigation into all of these comparisons is ultimately necessary.

Conclusions: SUAVR bridges the gap in technology between SAVR and TAVR. The application of this exciting technology will undoubtedly grow in the coming years, during which additional investigation is paramount to optimize preoperative planning, valve deployment, and reintervention strategies.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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