Assuntos
Pancreaticoduodenectomia , Pericárdio , Procedimentos Cirúrgicos Robóticos , Humanos , Pancreaticoduodenectomia/métodos , Pancreaticoduodenectomia/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Pericárdio/transplante , Animais , Bovinos , Procedimentos de Cirurgia Plástica/métodos , Veia Porta/cirurgia , Neoplasias Pancreáticas/cirurgia , Anastomose Cirúrgica/métodosRESUMO
INTRODUCTION: Aortic stenosis (AS) is the most common valvular heart disease and the most common indication for aortic valve replacement in adults. Aortic valve neocuspidization (AVNeo) with fixed autologous pericardium, also known as the Ozaki procedure, is a possible alternative treatment of AS. Autopericardial valves save the dynamics and physiological anatomy of the aortic root, however, the service life of autopericardial leaflets is limited. There is no data about factors that may influence the development of AVNeo insufficiency. Here, we assessed the effect of autopericardial leaflet symmetry on the development of aortic insufficiency after Ozaki procedure. METHODS: This study included 381 patients with AS who underwent Ozaki procedure. Patients were divided into group 1 (171 patients with symmetric aortic root) and group 2 (210 patients with asymmetric aortic root). RESULTS: The maximum observation period was up to 65 months. Sixteen cases of aortic insufficiency were detected in group 1, and 33 cases were detected in group 2. Based on the results of Cox regression, the predictors of aortic insufficiency in the late postoperative period are age and asymmetry of neocusps. According to results of Kaplan-Meier analysis, insufficiency of AVNeo in the maximum follow-up period after surgical correction of AS for group 1 patients was significantly lower than for group 2 patients (P=0.006). CONCLUSION: Asymmetric neocusps increase the risk of aortic insufficiency in the mid-term period after Ozaki procedure. And the older the patients at the time of surgery, the less likely they develop AVNeo insufficiency.
Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Doenças das Valvas Cardíacas , Próteses Valvulares Cardíacas , Adulto , Humanos , Valva Aórtica/cirurgia , Doenças das Valvas Cardíacas/cirurgia , Estenose da Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/cirurgia , Pericárdio/transplante , Resultado do TratamentoRESUMO
OBJECTIVE: To assess actual data on the safety, effectiveness, and hemodynamic performance of Bovine Pericardium Organic Valvular Bioprosthesis (BVP). METHODS: The BIOPRO Trial is an observational, retrospective, non-comparative, non-randomized, and multicenter study. We collected data from 903 patients with symptomatic, moderate, or severe valve disease who underwent BVP implants in the timeframe from 2013 to 2020 at three Brazilian institutions. Death, valve-related adverse events (AEs), functional recovery, and hemodynamic performance were evaluated at the hospital, at discharge, and six months and one year later. Primary analysis compared late (> 30 days after implant) linearized rates of valve-related AEs, such as thromboembolism, valve thrombosis, major hemorrhage, major paravalvular leak, and endocarditis, following objective performance criteria (OPC). Analysis was performed to include at least 400 valve-years for each valve position (aortic and mitral) for complete comparisons to OPC. Kaplan-Meier survival and major adverse cardiovascular and cerebrovascular event analyses were also performed. RESULTS: This retrospective study analyzed follow-up data collected from 903 patients (834.2 late patient-years) who have undergone surgery for 455 isolated aortic valve replacement (50.4%), 382 isolated mitral valve replacement (42.3%), and 66 combined valve replacement or other intervention (7.3%). The linearized rates of valve-related AEs were < 2 × OPC. One-year survival rates were 95.1% and 92.7% for aortic and mitral valve replacement, respectively. This study demonstrated an improvement in the New York Heart Association classification from baseline and hemodynamic performance within an expected range. CONCLUSION: According to this analysis, BVP meets world standards for safety and clinical efficacy.
Assuntos
Estenose da Valva Aórtica , Bioprótese , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Animais , Bovinos , Humanos , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Hemodinâmica , Pericárdio/transplante , Complicações Pós-Operatórias/etiologia , Desenho de Prótese , Estudos Retrospectivos , Resultado do TratamentoRESUMO
We report a 19-year-old woman with a history of percutaneous aortic valve (AV) balloon valvuloplasty 3 years ago. She was admitted with severe symptomatic AV stenosis with narrow aortic annulus. We decided to perform AV reconstruction with autologous pericardium. However, surgical findings revealed a very narrow AV annulus with a unicuspid valve; therefore, an AV enlargement was added.
Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Procedimentos Cirúrgicos Cardíacos , Feminino , Humanos , Adulto Jovem , Adulto , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Hospitalização , Pericárdio/transplante , Insuficiência da Valva Aórtica/cirurgiaRESUMO
Prosthetic valve replacement is the standard treatment for aortic valvulopathy. Due to the structural valve deterioration of biological prosthesis and the anticoagulation requirements of mechanical valves, the repair of aortic valve disease is receiving more attention in recent years. The Ozaki technique consists in the reconstruction of a trileaflet valve using autologous pericardium. We report our first two cases of successful reconstruction of the aortic valve using this technique with 12-month echocardiographic and 24-month clinical follow up.
Assuntos
Humanos , Próteses Valvulares Cardíacas , Doenças das Valvas Cardíacas/cirurgia , Valva Aórtica/cirurgia , Valva Aórtica/diagnóstico por imagem , Pericárdio/transplante , Transplante Autólogo/métodos , Ecocardiografia , Resultado do TratamentoRESUMO
Infective endocarditis is a rather uncommon disease, but it has significant mortality rates in the pediatric population (5% to 10%). We report a case of an infant patient with multiple vegetation in the tricuspid valve secondary to infective endocarditis caused by Corynebacterium diphtheriae. A tricuspid valvuloplasty was performed with a fenestrated autologous pericardium patch, providing satisfactory outcomes. This technique is simple, innovative, effective, and it could be applied in similar cases.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Endocardite Bacteriana , Endocardite , Criança , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Humanos , Pericárdio/cirurgia , Pericárdio/transplante , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgiaRESUMO
Abstract Infective endocarditis is a rather uncommon disease, but it has significant mortality rates in the pediatric population (5% to 10%). We report a case of an infant patient with multiple vegetation in the tricuspid valve secondary to infective endocarditis caused by Corynebacterium diphtheriae. A tricuspid valvuloplasty was performed with a fenestrated autologous pericardium patch, providing satisfactory outcomes. This technique is simple, innovative, effective, and it could be applied in similar cases.
Assuntos
Humanos , Criança , Endocardite , Endocardite Bacteriana/cirurgia , Endocardite Bacteriana/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos , Pericárdio/cirurgia , Pericárdio/transplante , Valva Tricúspide/cirurgia , Valva Tricúspide/diagnóstico por imagemRESUMO
Prosthetic valve replacement is the standard treatment for aortic valvulopathy. Due to the structural valve deterioration of biological prosthesis and the anticoagulation requirements of mechanical valves, the repair of aortic valve disease is receiving more attention in recent years. The Ozaki technique consists in the reconstruction of a trileaflet valve using autologous pericardium. We report our first two cases of successful reconstruction of the aortic valve using this technique with 12-month echocardiographic and 24-month clinical follow up.
Assuntos
Doenças das Valvas Cardíacas , Próteses Valvulares Cardíacas , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Ecocardiografia , Doenças das Valvas Cardíacas/cirurgia , Humanos , Pericárdio/transplante , Transplante Autólogo/métodos , Resultado do TratamentoRESUMO
Simultaneous pulmonary and aortic endocarditis is extremely rare, and there is no consensus on its surgical management. Here, we report a case of infective endocarditis of pulmonary and aortic valves complicated by severe pulmonary regurgitation due to complete damage of valve cusps. We performed pulmonary valve reconstruction using autologous pericardium using Ozaki's technique, with excellent outcomes.