Tesi etd-01232023-103613 |
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Tipo di tesi
Tesi di laurea magistrale LM6
Autore
DINI, MARTINA
URN
etd-01232023-103613
Titolo
Early echocardiographic evaluation after surgical aortic valve replacement with 3 different pericardial prostheses
Dipartimento
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Relatori
relatore Prof. Colli, Andrea
Parole chiave
- Aortic valve
- aortic valve replacement
- bioprostheses
- echocardiography evaluation
- mean gradients
- structural valve deterioration
Data inizio appello
14/02/2023
Consultabilità
Non consultabile
Data di rilascio
14/02/2093
Riassunto
Background: Bioprosthetic valve dysfunction is a major issue to lifetime durability for tissue valves, in Cardiac Surgery. Transthoracic echocardiography represents the gold standard imaging technique to evaluate bioprosthesis function after surgical aortic valve replacement.
Objective: The aim of this study is to evaluate early echocardiographic findings regarding a single-center surgical series of consecutive patients who underwent surgical aortic valve replacement with three different bovine pericardial aortic bioprostheses.
Methods: Data regarding baseline characteristics, echocardiographic data, intraoperative and postoperative outcomes were retrospectively collected.
Echocardiographic postoperative measurements were collected at discharge.
Results: A population of 249 patients was evaluated: three different groups that underwent surgical aortic valve replacement were identified, according to the implanted bioprosthesis. Transaortic valve mean gradients at discharge were statistically evaluated for each group by multiple linear regression, that showed a correlation between higher mean gradient values and smaller size of the bioprosthetic valves; moreover, the group treated with Carpentier-Edwards Perimount Magna Ease (Edwards Lifescience, Irvine, CA, USA) bioprosthesis appeared to have higher mean gradients at discharge.
Conclusions: A worse performance of the Carpentier-Edwards Perimount Magna Ease group was reported in early echocardiographic evaluation.
However, the minimal difference in overall mean gradients between the three evaluated valves could not be relevant in eventual long-term affection on left ventricle hypertrophy, function and patient mortality.
Since the recent availability of Inspiris Resilia bioprosthesis (Edwards Lifescience, Irvine, CA, USA), the present study analyzed only early postoperative data.
Therefore, these findings should be further evaluated by long term follow-up studies.
Objective: The aim of this study is to evaluate early echocardiographic findings regarding a single-center surgical series of consecutive patients who underwent surgical aortic valve replacement with three different bovine pericardial aortic bioprostheses.
Methods: Data regarding baseline characteristics, echocardiographic data, intraoperative and postoperative outcomes were retrospectively collected.
Echocardiographic postoperative measurements were collected at discharge.
Results: A population of 249 patients was evaluated: three different groups that underwent surgical aortic valve replacement were identified, according to the implanted bioprosthesis. Transaortic valve mean gradients at discharge were statistically evaluated for each group by multiple linear regression, that showed a correlation between higher mean gradient values and smaller size of the bioprosthetic valves; moreover, the group treated with Carpentier-Edwards Perimount Magna Ease (Edwards Lifescience, Irvine, CA, USA) bioprosthesis appeared to have higher mean gradients at discharge.
Conclusions: A worse performance of the Carpentier-Edwards Perimount Magna Ease group was reported in early echocardiographic evaluation.
However, the minimal difference in overall mean gradients between the three evaluated valves could not be relevant in eventual long-term affection on left ventricle hypertrophy, function and patient mortality.
Since the recent availability of Inspiris Resilia bioprosthesis (Edwards Lifescience, Irvine, CA, USA), the present study analyzed only early postoperative data.
Therefore, these findings should be further evaluated by long term follow-up studies.
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