دورية أكاديمية
Haemodynamic benefits of rapid deployment aortic valve replacement via a minimally invasive approach: 1-year results of a prospective multicentre randomized controlled trial.
| العنوان: | Haemodynamic benefits of rapid deployment aortic valve replacement via a minimally invasive approach: 1-year results of a prospective multicentre randomized controlled trial. |
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| المؤلفون: | Borger MA; Columbia University Medical Center, New York, NY, USA mb3851@cumc.columbia.edu., Dohmen PM; Leipzig Heart Center, Leipzig, Germany., Knosalla C; German Heart Institute Berlin, Berlin, Germany., Hammerschmidt R; German Heart Institute Berlin, Berlin, Germany., Merk DR; Leipzig Heart Center, Leipzig, Germany., Richter M; Jena University Hospital, Jena, Germany., Doenst T; Jena University Hospital, Jena, Germany., Conradi L; University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Treede H; University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Moustafine V; University Hospitals of the Ruhr University of Bochum, Bochum, Germany., Holzhey DM; Leipzig Heart Center, Leipzig, Germany., Duhay F; Edwards Lifesciences LLC, Irvine, CA, USA., Strauch J; University Hospitals of the Ruhr University of Bochum, Bochum, Germany. |
| المصدر: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2016 Oct; Vol. 50 (4), pp. 713-720. Date of Electronic Publication: 2016 Mar 02. |
| نوع المنشور: | Journal Article; Multicenter Study; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2012-: Oxford, England : Oxford University Press Original Publication: [Berlin] : Springer International ; [Secaucus, NJ, USA : Springer-Verlag New York Inc., distributor, c1987- |
| مواضيع طبية MeSH: | Heart Valve Prosthesis Implantation*/instrumentation , Heart Valve Prosthesis Implantation*/methods , Minimally Invasive Surgical Procedures*/methods, Aortic Valve Stenosis/*surgery, Aged ; Bioprosthesis ; Female ; Heart Valve Prosthesis ; Hemodynamics ; Humans ; Male ; Prospective Studies |
| مستخلص: | Objectives: Aortic valve replacement (AVR) via minimally invasive surgery (MIS) may provide clinical benefits in patients with aortic valve disease. A new class of bioprosthetic valves that enable rapid deployment AVR (RDAVR) may facilitate MIS. We here report the 1-year results of a randomized, multicentre trial comparing the outcomes for MIS-RDAVR with those for conventional AVR via full sternotomy (FS) with a commercially available stented aortic bioprosthesis. Methods: A total of 100 patients with aortic stenosis were enrolled in a prospective, multicentre, randomized comparison trial (CADENCE-MIS). Key exclusion criteria included AVR requiring concomitant procedures, ejection fraction of <25% and recent myocardial infarction or stroke. Patients were randomized to undergo MIS-RDAVR via upper hemisternotomy (EDWARDS INTUITY) or AVR via FS with a commercially available stented valve. Procedural, early and late clinical outcomes were assessed for both groups. Haemodynamic performance was evaluated by an echocardiography CoreLaboratory. Results: Technical success was achieved in 94% of MIS-RDAVR patients. MIS-RDAVR was associated with significantly reduced cross-clamp times compared with FS (41.3 ± 20.3 vs 54.0 ± 20.3 min, P < 0.001). Clinical and functional outcomes were similar at 30 days and 1 year postoperatively for both groups. While both groups received a similarly sized implanted valve (22.9 ± 2.1 mm MIS-RDAVR vs 23.0 ± 2.1 mm FS-AVR; P = 0.91), MIS-RDAVR patients had significantly lower peak gradients 1 year postoperatively (16.9 ± 5.3 vs 21.9 ± 8.6 mmHg; P = 0.033) and a trend towards lower mean gradients (9.1 ± 2.9 vs 11.5 ± 4.3 mmHg; P = 0.082). In addition, MIS-RDAVR patients had a significantly larger effective orifice area 1 year postoperatively (1.9 ± 0.5 vs 1.7 ± 0.4 cm 2 ; P = 0.047). Paravalvular leaks, however, were significantly more common in the MIS-RDAVR group (P = 0.027). Conclusions: MIS-RDAVR is associated with a significantly reduced cross-clamp time and better valvular haemodynamic function than FS-AVR. However, paravalvular leak rates are higher with MIS-RDAVR. (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Aortic valve replacement; Haemodynamics; Heart valve, Bioprosthesis; Minimally invasive |
| تواريخ الأحداث: | Date Created: 20160304 Date Completed: 20170821 Latest Revision: 20170821 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1093/ejcts/ezw042 |
| PMID: | 26935407 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1873-734X |
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| DOI: | 10.1093/ejcts/ezw042 |