Revival of Continuous Suture Technique in Aortic Valve Replacement in Patient with Aortic Valve Stenosis a Novel Modified Technique

2011 ◽  
Vol 6 (5) ◽  
pp. 311-315 ◽  
Author(s):  
Go Watanabe ◽  
Teruaki Ushijima ◽  
Shigeyuki Tomita ◽  
Shojiro Yamaguchi ◽  
Yoshinao Koshida ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Suture Technique ◽  
Continuous Suture ◽  
Cardiac Procedures ◽  
Group A ◽  
Group B

Objective The continuous suture technique has numerous advantages as simple, quick, and effective for aortic valve replacement; however, it is technically difficult. We have modified the continuous suture technique and evaluated our new technique in patients with aortic stenosis. Methods Between July 2007 and May 2010, 86 patients with aortic valve stenosis underwent aortic valve replacement alone or with other concomitant cardiac procedures including mitral valve surgery in our hospital. The patients were randomly divided into two groups: group A (n = 43) in which the continuous suture technique with some modifications was used and group B (n = 43) in which the conventional interrupted suture technique was used. There were no statistical differences between two groups in age, sex, body surface area, concomitant cardiac procedures, blood loss, and postoperative extubation time. Results The aortic cross-clamp time, cardiopulmonary bypass time, operation time, and hospital stay were significantly shorter in group A than that in group B, and the valve size was significantly larger in group A. No perivalvular leak was detected in postoperative echocardiograms. All patients recovered satisfactorily without complications associated with suture technique or prosthesis. During follow-up of 4 to 38 months, there were no clinically significant complications in group A, while one patient in group B developed perivalvular leakage requiring reoperation 3 months after surgery. Conclusions Our modified continuous suture method is useful for aortic valve replacement in patients with aortic stenosis and beneficial for the patients because the procedure is less invasive and a larger valve can be implanted.

scholarly journals Continuous Suture Technique for Aortic Valve Replacement

2018 ◽  
Vol 45 (2) ◽  
pp. 121-121 ◽  
Author(s):  
Mi Kyung Lee ◽  
Jong Bum Choi ◽  
Nan Yeol Kim
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Suture Technique ◽  
Continuous Suture

scholarly journals Transcatheter Aortic Valve Replacement in Aortic Stenosis: a Clinical Case

2021 ◽  
Vol 11 (1) ◽  
pp. 29-32
Author(s):  
V. V. Plechev ◽  
V. Sh. Ishmetov ◽  
A. V. Pavlov ◽  
R. E. Abdrakhmanov ◽  
T. R. Ibragimov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Transcatheter Aortic Valve Replacement ◽  
Open Surgery ◽  
Valve Calcification ◽  
Transcatheter Aortic Valve

Background. Aortic valve stenosis is common with prevalence of about 0.5 %, peaking in people aged over 70 years mostly due to age-related valve calcification. The year 2002 was marked by the invention and use of the endovascular aortic replacement valve by an A. Cribier’s group of French surgeons. Russian endovascular surgery introduced transcatheter aortic valve replacement in 2009, having since built an extensive experience in this practice. Perioperative mortality in patients under 70 years with no serious comorbidity ranges from 1 to 3 %, however, reaching two-fold 4–8 % in elderly patients. The emergence of minimally invasive technologies offered cure to critical patients, who would merely not get over an open surgery.Materials and methods. This case study provides video recordings of transcatheter aortic valve replacement (Accurate Neo) in transfemoral approach performed for the first time in the Republic of Bashkortostan. Patient K., 70 yo, diagnosis: Atherosclerosis. Aortic valve stenosis. FC III. Complications: aortic valve calcification st. III, CHF II A, FC III, persistent atrial fibrillation, tachysystole. Comorbid: CHD. Exertional angina. FC III. CHF II A, FC III.Results and discussion. Improving the transcatheter valve type facilitates an optimal individual aortic valve selection. Pre-replacement valvuloplasty was performed in all patients. The valve replacement is followed by transoesophageal echocardiography to justify possible aortic valve post-dilatation upon marked paravalvular regurgitation. The implant positioning relative to the aortic valve fibrous crown and mitral valve flaps is precisely controlled with ultrasound.Conclusion. Interventional radiology currently provides high-quality, effective, minimally invasive medical aid even in aortic stenosis patients with multiple comorbidity. In the patient’s denial of open surgery, transcatheter aortic valve replacement represents a sole alternative treatment, also increasing the life expectancy and quality. A wider diversity of available transcatheter devices enables a better personalisation of the biological valve replacement procedure.

Transcatheter Aortic Valve Replacement

2018 ◽  
Vol 13 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Seyed Hossein Aalaei-Andabili ◽  
R. David Anderson ◽  
Anthony A. Bavry ◽  
Teng C. Lee ◽  
Siddharth Wayangankar ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Injury Rate ◽  
Operation Time ◽  
Transcatheter Aortic Valve ◽  
Group A ◽  
Group B ◽  
Over Time

Objective Transcatheter aortic valve replacement is now commercially available for intermediate-risk, high-risk, or inoperable patients with severe aortic stenosis. In this study, we investigated change in the safety and efficiency of the transcatheter aortic valve replacement procedure at our institution and patient outcomes comparing our first 100, second 100, and last 100 patients. Methods From March 2012 to June 2016, 544 patients underwent transcatheter aortic valve replacement at our center. Three hundred patients were selected for this study and were categorized in the following three groups: group A, first to 100th patient; group B, 101st to 200th patient; and group C, 444th to 544th patient. Preoperative, intraoperative, and postoperative data were collected. Results Three hundred patients, 162 male (54%) male and 138 female (46%) with a mean ± SD age of 79.10 ± 8.93 years and mean ± SD society of thoracic surgeons’ risk score of 7.47 ± 0.76 were included. Fluoroscopy time, operation time, and incision time significantly decreased form group A to group C (all P < 0.05). Mean of contrast volume was also the highest in group A and the lowest in group C ( P < 0.001). Acute kidney injury rate was 26% (n = 26) in group A versus 23% (n = 23) in group B ( P = 0.743), and only one patient in group C (group C vs. group B, P < 0.001). Strokes declined over time: five (5%) stroke in group A; two (2%) stroke in group B, and no patient in group C (group C vs. group B, P = 0.1, and group C vs. group A, P = 0.059). In-hospital mortality was 5% (n = 5) in group A, 4% (n = 4) in group B, and 1% in group C ( P = 0.21). Conclusions Progressive experience and technology advances with transcatheter aortic valve replacement procedures improved operators’ expertise, making the transcatheter aortic valve replacement more efficient and safer over time.

Continuous-Suture Technique in Aortic Valve Replacement

2006 ◽  
Vol 21 (2) ◽  
pp. 178-181 ◽  
Author(s):  
He Qicai ◽  
Chen Zili ◽  
He Zhengfu ◽  
Zhang Weiming ◽  
Chen Zhoumiao ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Suture Technique ◽  
Continuous Suture

Aortic Valve Replacement Using a Continuous Suture Technique

1993 ◽  
Vol 8 (4) ◽  
pp. 459-465 ◽  
Author(s):  
Hillel Laks ◽  
Jeffrey M. Pearl ◽  
Steven W. Barthel ◽  
Amir Elami ◽  
Thomas J. Sorensen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Suture Technique ◽  
Continuous Suture

scholarly journals Continuous Suture Technique for Aortic Valve Replacement Shortens Cross-Clamp and Bypass Times

2017 ◽  
Vol 44 (6) ◽  
pp. 390-394 ◽  
Author(s):  
Tadashi Kitamura ◽  
James Edwards ◽  
Kagami Miyaji
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Suture Technique ◽  
Paravalvular Leak ◽  
Continuous Suture ◽  
Surgical Aortic Valve Replacement ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time

The interrupted noneverting mattress suture technique is typically used in conventional surgical aortic valve replacement. The continuous suture technique, although faster, has been associated with a higher incidence of paravalvular leak. Using a slightly modified technique to minimize this risk, we investigated whether continuous suturing would shorten aortic cross-clamp time in aortic valve replacement in comparison with interrupted suturing. We reviewed the cases and compared the perioperative data of 60 consecutive patients in Japan and Australia (35 men and 25 women; median age, 70 yr) who had undergone aortic valve replacement with or without septal myectomy. The continuous suture technique had been used in 41 patients (Group CS) and the standard interrupted suture technique in 19 (Group IS). The groups were similar in age, sex, pathologic valvular conditions, and operative urgency. In Group CS, aortic cross-clamp time (47 vs 63 min; P=0.0001) and cardiopulmonary bypass time (76 vs 89 min; P=0.04) were significantly shorter. Neither group had early paravalvular leak. Using our continuous suture technique safely shortened aortic cross-clamp time during surgical aortic valve replacement.

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