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Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures
- Source :
- Texas Heart Institute journal. 45(1)
- Publication Year :
- 2018
-
Abstract
- In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34–93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1. In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P=0.001), postoperative drainage amounts were lower (P=0.009), hospital stays were shorter (P=0.004), and less red blood cell transfusion was needed (P=0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P=0.012). We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.
- Subjects :
- Adult
Male
medicine.medical_specialty
genetic structures
Heart Diseases
Turkey
Aortic Valve Insufficiency
Hemodynamics
030204 cardiovascular system & hematology
Prosthesis Design
law.invention
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Aortic valve replacement
law
Diabetes mellitus
Cardiac procedures
medicine
Cardiopulmonary bypass
Humans
Prospective Studies
Clinical Investigation
Cardiac Surgical Procedures
Prospective cohort study
Aged
Aged, 80 and over
High risk patients
business.industry
Middle Aged
medicine.disease
Sutureless Surgical Procedures
Surgery
Survival Rate
Treatment Outcome
030228 respiratory system
Concomitant
Aortic Valve
cardiovascular system
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15266702
- Volume :
- 45
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Texas Heart Institute journal
- Accession number :
- edsair.doi.dedup.....34265ef8cc2a0c74d9f23738b7a5b06b