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Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch
BACKGROUND: While the pledget suture technique has been the standard for surgical aortic. valve replacement (AVR), discussion continues regarding the possibility of the nonpledget suture technique to produce superior structural and hemodynamic parameters. This study aims to assess the effectiveness...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084672/ https://www.ncbi.nlm.nih.gov/pubmed/37038197 http://dx.doi.org/10.1186/s13019-023-02260-y |
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author | Rasheed, Nabeel F. Stonebraker, Corinne Li, Zhaozhi Siddiqi, Umar Lee, Andy C. H. Li, Willa Lupo, Sydney Cruz, Jennifer Cohen, William G. Staub, Cathy Rodgers, Daniel Myren, Mark Combs, Pamela Jeevanandam, Valluvan Hibino, Narutoshi |
author_facet | Rasheed, Nabeel F. Stonebraker, Corinne Li, Zhaozhi Siddiqi, Umar Lee, Andy C. H. Li, Willa Lupo, Sydney Cruz, Jennifer Cohen, William G. Staub, Cathy Rodgers, Daniel Myren, Mark Combs, Pamela Jeevanandam, Valluvan Hibino, Narutoshi |
author_sort | Rasheed, Nabeel F. |
collection | PubMed |
description | BACKGROUND: While the pledget suture technique has been the standard for surgical aortic. valve replacement (AVR), discussion continues regarding the possibility of the nonpledget suture technique to produce superior structural and hemodynamic parameters. This study aims to assess the effectiveness of the figure-of-eight suture technique in AVR, as determined by the incidence of prosthesis-patient mismatch (PPM). METHODS: We reviewed records of patients (N = 629) who underwent a surgical AVR procedure between January 2011 and July 2018 at a single institution. Indexed effective orifice area values and PPM incidence were calculated from implanted valve size and patient body surface area. Incidence of none, moderate, and severe PPM was compared across AVR suture techniques. RESULTS: A total of 570 pledget and 59 figure-of-eight patients were compared for incidence of PPM. Patients who received AVR with the pledget suture technique had significantly lower echocardiographic measurements of baseline ejection fraction than patients who had received AVR with the figure-of-eight suture technique (p = 0.003). Patients who received the figure-of eight suture had a 14% decrease in moderate PPM compared to patients who received the pledget suture (p = 0.022). Patients who received the figure-of-eight suture also had a significantly higher rate of no PPM (p = 0.044). CONCLUSIONS: The use of the figure-of-eight suture technique in AVR can reduce the incidence of moderate PPM. While the pledget suture is the standard technique in AVR, the figure-of-eight suture technique may offer better structural and hemodynamic outcomes, especially for patients with a smaller aortic annulus. |
format | Online Article Text |
id | pubmed-10084672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100846722023-04-11 Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch Rasheed, Nabeel F. Stonebraker, Corinne Li, Zhaozhi Siddiqi, Umar Lee, Andy C. H. Li, Willa Lupo, Sydney Cruz, Jennifer Cohen, William G. Staub, Cathy Rodgers, Daniel Myren, Mark Combs, Pamela Jeevanandam, Valluvan Hibino, Narutoshi J Cardiothorac Surg Research BACKGROUND: While the pledget suture technique has been the standard for surgical aortic. valve replacement (AVR), discussion continues regarding the possibility of the nonpledget suture technique to produce superior structural and hemodynamic parameters. This study aims to assess the effectiveness of the figure-of-eight suture technique in AVR, as determined by the incidence of prosthesis-patient mismatch (PPM). METHODS: We reviewed records of patients (N = 629) who underwent a surgical AVR procedure between January 2011 and July 2018 at a single institution. Indexed effective orifice area values and PPM incidence were calculated from implanted valve size and patient body surface area. Incidence of none, moderate, and severe PPM was compared across AVR suture techniques. RESULTS: A total of 570 pledget and 59 figure-of-eight patients were compared for incidence of PPM. Patients who received AVR with the pledget suture technique had significantly lower echocardiographic measurements of baseline ejection fraction than patients who had received AVR with the figure-of-eight suture technique (p = 0.003). Patients who received the figure-of eight suture had a 14% decrease in moderate PPM compared to patients who received the pledget suture (p = 0.022). Patients who received the figure-of-eight suture also had a significantly higher rate of no PPM (p = 0.044). CONCLUSIONS: The use of the figure-of-eight suture technique in AVR can reduce the incidence of moderate PPM. While the pledget suture is the standard technique in AVR, the figure-of-eight suture technique may offer better structural and hemodynamic outcomes, especially for patients with a smaller aortic annulus. BioMed Central 2023-04-10 /pmc/articles/PMC10084672/ /pubmed/37038197 http://dx.doi.org/10.1186/s13019-023-02260-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Rasheed, Nabeel F. Stonebraker, Corinne Li, Zhaozhi Siddiqi, Umar Lee, Andy C. H. Li, Willa Lupo, Sydney Cruz, Jennifer Cohen, William G. Staub, Cathy Rodgers, Daniel Myren, Mark Combs, Pamela Jeevanandam, Valluvan Hibino, Narutoshi Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title | Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title_full | Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title_fullStr | Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title_full_unstemmed | Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title_short | Figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
title_sort | figure of eight suture technique in aortic valve replacement decreases prosthesis-patient mismatch |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084672/ https://www.ncbi.nlm.nih.gov/pubmed/37038197 http://dx.doi.org/10.1186/s13019-023-02260-y |
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