Abstract:
OBJECTIVES:The superiority of supra-annular aortic prostheses over intra-annular equivalents in long-term haemodynamics and clinical outcomes remains controversial. This study compared outcomes among patients receiving supra-annular or intra-annular prostheses during aortic valve replacement. METHODS:We enrolled 587 consecutive patients (mean age 55.1 ± 11.3 years; 188 women) undergoing aortic valve replacement with either supra-annular (n = 316) or intra-annular (n = 271) mechanical prostheses between 2000 and 2016 in our institute. Clinical outcomes and haemodynamic profiles in the 2 groups were compared after propensity score adjustment. RESULTS:Early death (1.1% vs 0.6%; P = 0.863) was equivalent for both groups. Patients receiving supra-annular prostheses showed a lower rate of patient-prosthesis mismatch (1.2% vs 25.8%; P < 0.001). During a median follow-up of 65 months (quartile 1-3, 30-108 months), overall deaths occurred in 84 (14.3%) patients. The latest echocardiographic assessment in the 136 propensity score-matched pairs demonstrated superior haemodynamics with implantation of supra-annular prostheses: peak velocity (2.7 ± 0.6 vs 2.3 ± 0.5 m/s; P < 0.001), mean pressure gradient (16.5 ± 9.0 vs 12.0 ± 6.2 mmHg; P < 0.001) and left ventricular mass index (113.6 ± 30.3 vs 105.3 ± 26.3 g/m2; P = 0.016). After adjusting with inverse-probability-of-treatment weighting, however, the choice of supra-annular over intra-annular prosthesis did not significantly affect the risk of overall mortality (P = 0.693) or major adverse events: stroke (P = 0.944), infective endocarditis (P = 0.958) and reoperation (P = 0.944). CONCLUSIONS:The implantation of supra-annular prostheses resulted in superior haemodynamics and left ventricular mass regression, while conferring no apparent clinical benefits. Follow-up studies are required to further evaluate the impact of superior haemodynamics associated with supra-annular prostheses on long-term clinical outcomes.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Kim SH,Kim HJ,Kim JB,Jung SH,Choo SJ,Chung CH,Lee JWdoi
10.1093/icvts/ivy190subject
Has Abstractpub_date
2019-01-01 00:00:00pages
58-64issue
1eissn
1569-9293issn
1569-9285pii
5052244journal_volume
28pub_type
杂志文章abstract:OBJECTIVE:Pulmonary lobectomy for lung cancer is a well-established and safe operation. This report serves to highlight an important complication and an underlying essential surgical principle when performing pulmonary resections, to avoid a potentially fatal outcome. METHODS:A case report is presented. We describe an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00188-9
更新日期:2003-12-01 00:00:00
abstract::Shed blood is known to be a source of lipid micro-emboli in cardiac surgery. The aim of this study was to characterize the occurrence of these particles at different stages of the operation, and to study their occurrence in the circulation at multiple time-points after the retransfusion of shed blood. Forty-four patie...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.187021
更新日期:2009-05-01 00:00:00
abstract::Diagnosis of cardiac myxoma is typically suggested in the presence of symptoms and echocardiographic findings of an intracardiac mass and confirmed histologically. Coronary angiography (CA) and cardiac magnetic-resonance-imaging (MRI) may provide specific additional information which could lead to a precise preoperati...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.154096
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:Management of malignant tumours of the heart remains a poorly investigated clinical area due to the scarcity of presentations. The purpose of this series and review is to present an outline of the management emphasized by our personal experience in a regional cardiothoracic centre. METHODS:We reviewed all c...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs350
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:Recent evidence shows that permissive anaemia strategies are safe in different surgical settings. However, effects of variations in haemoglobin (Hb) levels could have a negative impact in high-risk patients. We investigated the combined effect of postoperative Hb concentration and cardiac risk status on majo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz199
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:Perioperative myocardial infarction (MI) with ischaemia-reperfusion injury (IRI) is a devastating entity occurring in 1-2% of patients after cardiac surgery. The molecular pathway leading to myocardial cellular destruction after MI may include monoamine oxidases. We experimentally investigated whether moclob...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv175
更新日期:2015-10-01 00:00:00
abstract::Inflow or outflow obstruction is a rare, but critical complication after HeartMate 3 left ventricular assist device implantation. We retrospectively reviewed 166 patients who underwent primary HeartMate 3 implantation at our centre between November 2014 and July 2019. Three cases of inflow obstruction and 3 cases of o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa158
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:Female gender is reported as an independent risk factor for a poor outcome after coronary artery bypass grafting. We analysed the influence of gender on surgical outcome in patients with single-vessel disease undergoing minimally invasive direct coronary artery bypass (MIDCAB). METHODS:From January 1998 to ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz279
更新日期:2020-03-01 00:00:00
abstract::Success of the modified maze procedure after valvular operation with giant atria and permanent atrial fibrillation (AF) remains suboptimal. We report an aggressive approach for these patients utilizing biatrial reduction plasty with a reef imbricate suture technique concomitantly with valvular and maze procedure for A...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.220012
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:To explore the rule of subcarinal lymph node metastasis in thoracic oesophageal cancer and its clinical significance in the radical resection of oesophageal cancer. METHODS:We retrospectively analysed 2223 patients with oesophageal cancer who were admitted to Henan Cancer Hospital during 2004-2011 and under...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt070
更新日期:2013-06-01 00:00:00
abstract::We report a case of an 18-year old female patient with symptomatic extralobar pulmonary sequestration. The initial symptom was sudden-onset right lateral abdominal pain. Enhanced computed tomography showed a 5 cm in diameter, spindle-shaped mass located in the costophrenic sinus with no aberrant artery. Exploratory th...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu103
更新日期:2014-08-01 00:00:00
abstract:Objectives:We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. Methods:In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw379
更新日期:2017-04-01 00:00:00
abstract::Pulmonary sequestration is a relatively rare but clinically significant form of congenital broncho-pulmonary foregut malformation. It is characterized by a segment of non-functioning lung parenchyma that receives its blood supply from anomalous systemic arteries. This report shows the role of contrast enhanced three-d...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00118-X
更新日期:2003-12-01 00:00:00
abstract::Coexistence of multiple peripheric arterial and coronary artery aneurysms of different sizes is extremely rare in young adults. We present a case of rare giant coronary aneurysm and concurrent giant left popliteal aneurysm treated with classical open repair. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv372
更新日期:2016-04-01 00:00:00
abstract::Wound breakdown is a serious complication of median sternotomy. This is generally met with a further attempt at surgical apposition using sutures of monofilament surgical steel, following wound debridement. This often fails. The aim of this article is to demonstrate one surgeon's experience in his revised management o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.101147
更新日期:2005-12-01 00:00:00
abstract::The natural history of the LV systolic function (LV-SF) and functional capacity of survivors of heart transplantation (Htx) has not been defined. Some investigators suggest that SF may be different in recipients with different pre-transplant aetiologies: ischaemic or dilated, idiopathic disease. Routine transthoracic ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.167924
更新日期:2008-08-01 00:00:00
abstract::The rotary blood pump (the HeartWare® Ventricular Assist Device) from HeartWare® (Medtronic) is an established left ventricular assist device and usually implanted via sternotomy. To reduce the invasiveness of the implant procedure and to optimize the position of the inflow cannula, we propose an alternative implant t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy183
更新日期:2018-12-01 00:00:00
abstract::Embolization of a percutaneous left atrial appendage occlusion device is a rare, but potentially life-threatening, complication. In this report, we present the case of an embolization of such a device into the left ventricular outflow tract causing extensive damage to the mitral subvalvular apparatus and requiring mit...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy290
更新日期:2019-04-01 00:00:00
abstract::Acute aortic occlusion with subsequent ischemia-reperfusion of the lower extremities is well known to predispose to lung injury. Melatonin (MEL), a pineal hormone, is a free radical scavenger and an antioxidant. The purpose of this study was to assess the putative protective role of MEL in lung ischemia-reperfusion in...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/j.icvts.2004.05.005
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:The percutaneous coronary artery angioplasty is routinely being used worldwide for the management of short and discrete coronary artery stenosis. The purpose of this report is to address the potentially lethal complication among the variety of surgical problems in conjunction with this procedure. The case al...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.140194
更新日期:2007-02-01 00:00:00
abstract::Aprotinin reduces bleeding and transfusion rates in patients undergoing coronary surgery while on clopidogrel. However, safety studies have indicated that aprotinin may have a possible adverse effect related to an increased incidence of thromboembolic events. We therefore studied the adenosinediphosphate (ADP) mediate...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.206342
更新日期:2009-08-01 00:00:00
abstract::Of 428 patients, mean age of 64.1+/-9.2 (30-84 years), undergoing an isolated CABG, pre- and one-year- postoperatively angina level and quality of life (QOL) were registered. QOL was registered following the EuroQol-registration, five domains and a visual analogue scale (VAS). Based on the VAS, the group was divided i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.120113
更新日期:2006-04-01 00:00:00
abstract::A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether gabapentin, a commonly prescribed neuropathic analgesic and anticonvulsant, is safe and beneficial in patients with post-thoracotomy pain following thoracic surgery. Seventeen papers were ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt301
更新日期:2013-10-01 00:00:00
abstract::Coarctation of thoracic aorta is an uncommon diagnosis in adults. Catheter-based intervention consisting of primary ballooning and stenting is becoming one of the methods of choice for the treatment of native coarctation. We describe the case of a young adult with coarctation of the aorta treated unsuccessfully with p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.265264
更新日期:2011-07-01 00:00:00
abstract::A best evidence topic was written according to a structured protocol. The question addressed was whether the reimplantation (David) technique or the remodeling (Yacoub) technique provides the optimum event free survival in patients with an aortic root aneurysm suitable for an aortic valve-sparing operation. In total, ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.267401
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Our institution adopted a lateral thoracotomy approach to epicaridal pacemaker implantation with the objective of avoiding epicardial scar tissue and to achieve adequate lead pacing and sensing. We sought to assess the short-term outcomes of this approach. METHODS:A single-centre review was conducted in pae...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx379
更新日期:2018-05-01 00:00:00
abstract::There is still no consensus on the optimal management to treat pediatric mediastinitis. We assessed the efficacy of continuous irrigation and vacuum-assisted closure (VAC) for mediastinitis in children. This study retrospectively reviewed 20 patients aged <5 years with mediastinitis from December 2002 to December 2009...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.235903
更新日期:2010-09-01 00:00:00
abstract::The nasogastric tube is used extensively in medical practice. However, this innocent-looking tube can at times cause unexpected complications especially in patients with preexisting risk factors. A 25-year-old male was referred to our hospital with a blocked and impacted nasogastric tube which had been inserted to mai...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.157065
更新日期:2007-08-01 00:00:00
abstract::A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: is it safe to stop anticoagulants after successful surgery for atrial fibrillation? Altogether, 177 papers were found using the reported search, of which 14 were selected that represented the bes...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2011.282319
更新日期:2011-12-01 00:00:00
abstract::The aim of this study was to investigate the overall outcome of adult patients undergoing redo-mitral valve replacement (redo-MVR) at our institution. Forty-nine patients (24 males) underwent redo-MVR with either bioprosthetic (n = 24) or mechanical valves (n = 25) between January 2000 and 2010. Median age of patients...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs005
更新日期:2012-05-01 00:00:00