دورية أكاديمية
Standardized approach to valve repair using an expansible aortic ring versus mechanical Bentall: early outcomes of the CAVIAAR multicentric prospective cohort study
| العنوان: | Standardized approach to valve repair using an expansible aortic ring versus mechanical Bentall: early outcomes of the CAVIAAR multicentric prospective cohort study |
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| المؤلفون: | Lansac, E., Bouchot, O., Arnaud Crozat, E., Hacini, R., Doguet, F., Demaria, R., Leguerrier, A., Jouan, J., Chatel, D., Lopez, S., Folliguet, T., Acar, C., Leprince, P., Langanay, T., Jegaden, Olivier, Bessou, J. P., Albat, B., Latremouille, C., Fabiani, J. N., Fayad, G., Fleury, J. P., Pasquet, B., Debauchez, M., Di Centa, I., Tubach, F. |
| المساهمون: | Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| المصدر: | ISSN: 0022-5223 ; Journal of Thoracic and Cardiovascular Surgery ; https://hal.archives-ouvertes.fr/hal-01850674Test ; Journal of Thoracic and Cardiovascular Surgery, Elsevier, 2015, 149 (2 Suppl), pp.S37-45. ⟨10.1016/j.jtcvs.2014.07.105⟩. |
| بيانات النشر: | HAL CCSD Elsevier |
| سنة النشر: | 2015 |
| المجموعة: | Archive ouverte HAL (Hyper Article en Ligne, CCSD - Centre pour la Communication Scientifique Directe) |
| مصطلحات موضوعية: | Aortic Valve/*abnormalities/surgery, Patient Preference, Postoperative Complications/mortality/surgery, Aortic Aneurysm/diagnosis/mortality/*surgery, Cardiac Valve Annuloplasty/adverse effects/mortality, Blood Vessel Prosthesis Implantation/adverse effects/mortality, Heart Valve Prosthesis, Odds Ratio, Multivariate Analysis, Chi-Square Distribution, Treatment Outcome, Young Adult, Risk Factors, 80 and over, Prospective Studies, Middle Aged, Logistic Models, Time Factors, Aged, Male, France, Humans, Female, Heart Valve Diseases/diagnosis/mortality/*surgery, Heart Valve Prosthesis Implantation/adverse effects/*instrumentation/mortality, Disease-Free Survival, Adult, Propensity Score, Reoperation, Prosthesis Design |
| الوصف: | International audience ; OBJECTIVE: The study objective was to compare the 30-day outcomes of a standardized aortic valve repair technique (REPAIR group) associating root remodeling with an expansible aortic ring annuloplasty versus mechanical composite valve and graft (CVG group) replacement in treating aortic root aneurysms. METHODS: A total of 261 consecutive patients with aortic root aneurysm were enrolled in this multicentric prospective cohort (131 in the CVG group, 130 in the REPAIR group) in 20 centers. The main end point is a composite criterion including mortality; reoperation; thromboembolic, hemorrhagic, or infectious events; and heart failure. Secondary end points were major adverse valve-related events. Crude and propensity score adjusted estimates are provided. RESULTS: The mean age was 56.1 years, and the valve was bicuspid in 115 patients (44.7%). The median (interquartile range) preoperative aortic insufficiency grade was 2.0 (1.0-3.0) in the REPAIR group and 3.0 (2.0-3.0) in the CVG group (P = .0002). Thirty-day mortality was 3.8% (n = 5) in both groups (P = 1.00). Despite a learning curve and longer crossclamp times for valve repair (147.7 vs 99.8 minutes, P \textless .0001), the 2 groups did not differ significantly for the main criterion (odds ratio, 1.31; 95% confidence interval, 0.72-2.40; P = .38) or 30-day mortality (odds ratio, 0.99; 95% confidence interval, 0.28-3053; P = .99), with a trend toward more frequent major adverse valve-related events in the CVG group (odds ratio, 2.52; 95% confidence interval, 0.86-7.40; P = .09). At discharge, 121 patients (96.8%) in the REPAIR group had grade 0 or 1 aortic insufficiency. CONCLUSIONS: A new standardized approach to valve repair, combining an expansible aortic annuloplasty ring with the remodeling technique, presented similar 30-day results to mechanical CVG with a trend toward reducing major adverse valve-related events. Analysis of late outcomes is in process for 3- and 10-year follow-ups. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-01850674; https://hal.archives-ouvertes.fr/hal-01850674Test |
| DOI: | 10.1016/j.jtcvs.2014.07.105 |
| الإتاحة: | https://doi.org/10.1016/j.jtcvs.2014.07.105Test https://hal.archives-ouvertes.fr/hal-01850674Test |
| رقم الانضمام: | edsbas.AE144645 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jtcvs.2014.07.105 |
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