Abstract
Objective: A supra-annular aortic valve prosthesis is often used for aortic valve replacement in patients with a small aortic annulus. However, which suture technique provides the best valve performance has not been studied. We aimed to compare valve performance between 2 different suture techniques. Methods: We reviewed 152 patients undergoing aortic valve replacement with a 19- or 21-mm Carpentier-Edwards Perimount Magna aortic bioprosthesis (Edwards Lifesciences, Irvine, Calif) between June 2008 and December 2010. Simple interrupted sutures were used in 102 patients (group A, 19-mm prosthesis in 47 patients and 21-mm prosthesis in 55 patients), and noneverting mattress sutures were used in 50 patients (group B, 19-mm prosthesis in 20 patients and 21-mm prosthesis in 30 patients). Transthoracic echocardiograms were performed at baseline and before discharge in all patients and 1 year after surgery in 141 patients. We compared the effective orifice area and incidence of prosthesis-patient mismatch (effective orifice area index <0.85 cm 2 /m 2 ) between 2 groups. Results: The mean postoperative effective orifice areas were 1.41 ± 0.32 cm 2 /m 2 in group A and 1.30 ± 0.28 cm 2 /m 2 in group B (P =.025). The incidence of prosthesis-patient mismatch was 29% in group A and 56% in group B (P =.002). A multivariate analysis has shown that simple interrupted suturing is a negative predictor of prosthesis-patient mismatch (odds ratio, 0.33; 95% confidence interval, 0.13-0.83; P =.018). At 1 year, the incidence of prosthesis-patient mismatch was 27% in group A and 47% in group B (P =.023). Conclusions: Simple interrupted sutures provide larger effective orifice areas and reduce the incidence of prosthesis-patient mismatch after aortic valve replacement with a small supra-annular bioprosthesis. This suture technique is preferred in those patients to maximize valve performance.
| Original language | English |
|---|---|
| Pages (from-to) | 321-325 |
| Number of pages | 5 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 147 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Simple interrupted suturing increases valve performance after aortic valve replacement with a small supra-annular bioprosthesis. / Tabata, Minoru; Shibayama, Kentaro; Watanabe, Hiroyuki; Sato, Yasunori; Fukui, Toshihiro; Takanashi, Shuichiro.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 147, No. 1, 01.01.2014, p. 321-325.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Simple interrupted suturing increases valve performance after aortic valve replacement with a small supra-annular bioprosthesis
AU - Tabata, Minoru
AU - Shibayama, Kentaro
AU - Watanabe, Hiroyuki
AU - Sato, Yasunori
AU - Fukui, Toshihiro
AU - Takanashi, Shuichiro
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Objective: A supra-annular aortic valve prosthesis is often used for aortic valve replacement in patients with a small aortic annulus. However, which suture technique provides the best valve performance has not been studied. We aimed to compare valve performance between 2 different suture techniques. Methods: We reviewed 152 patients undergoing aortic valve replacement with a 19- or 21-mm Carpentier-Edwards Perimount Magna aortic bioprosthesis (Edwards Lifesciences, Irvine, Calif) between June 2008 and December 2010. Simple interrupted sutures were used in 102 patients (group A, 19-mm prosthesis in 47 patients and 21-mm prosthesis in 55 patients), and noneverting mattress sutures were used in 50 patients (group B, 19-mm prosthesis in 20 patients and 21-mm prosthesis in 30 patients). Transthoracic echocardiograms were performed at baseline and before discharge in all patients and 1 year after surgery in 141 patients. We compared the effective orifice area and incidence of prosthesis-patient mismatch (effective orifice area index <0.85 cm 2 /m 2 ) between 2 groups. Results: The mean postoperative effective orifice areas were 1.41 ± 0.32 cm 2 /m 2 in group A and 1.30 ± 0.28 cm 2 /m 2 in group B (P =.025). The incidence of prosthesis-patient mismatch was 29% in group A and 56% in group B (P =.002). A multivariate analysis has shown that simple interrupted suturing is a negative predictor of prosthesis-patient mismatch (odds ratio, 0.33; 95% confidence interval, 0.13-0.83; P =.018). At 1 year, the incidence of prosthesis-patient mismatch was 27% in group A and 47% in group B (P =.023). Conclusions: Simple interrupted sutures provide larger effective orifice areas and reduce the incidence of prosthesis-patient mismatch after aortic valve replacement with a small supra-annular bioprosthesis. This suture technique is preferred in those patients to maximize valve performance.
AB - Objective: A supra-annular aortic valve prosthesis is often used for aortic valve replacement in patients with a small aortic annulus. However, which suture technique provides the best valve performance has not been studied. We aimed to compare valve performance between 2 different suture techniques. Methods: We reviewed 152 patients undergoing aortic valve replacement with a 19- or 21-mm Carpentier-Edwards Perimount Magna aortic bioprosthesis (Edwards Lifesciences, Irvine, Calif) between June 2008 and December 2010. Simple interrupted sutures were used in 102 patients (group A, 19-mm prosthesis in 47 patients and 21-mm prosthesis in 55 patients), and noneverting mattress sutures were used in 50 patients (group B, 19-mm prosthesis in 20 patients and 21-mm prosthesis in 30 patients). Transthoracic echocardiograms were performed at baseline and before discharge in all patients and 1 year after surgery in 141 patients. We compared the effective orifice area and incidence of prosthesis-patient mismatch (effective orifice area index <0.85 cm 2 /m 2 ) between 2 groups. Results: The mean postoperative effective orifice areas were 1.41 ± 0.32 cm 2 /m 2 in group A and 1.30 ± 0.28 cm 2 /m 2 in group B (P =.025). The incidence of prosthesis-patient mismatch was 29% in group A and 56% in group B (P =.002). A multivariate analysis has shown that simple interrupted suturing is a negative predictor of prosthesis-patient mismatch (odds ratio, 0.33; 95% confidence interval, 0.13-0.83; P =.018). At 1 year, the incidence of prosthesis-patient mismatch was 27% in group A and 47% in group B (P =.023). Conclusions: Simple interrupted sutures provide larger effective orifice areas and reduce the incidence of prosthesis-patient mismatch after aortic valve replacement with a small supra-annular bioprosthesis. This suture technique is preferred in those patients to maximize valve performance.
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U2 - 10.1016/j.jtcvs.2012.11.020
DO - 10.1016/j.jtcvs.2012.11.020
M3 - Article
VL - 147
SP - 321
EP - 325
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 1
ER -