| The safety and efficacy of pannus removal or aortic valve re-replacement evaluated by transthoracic echocardiogram |
| Received:June 06, 2022 Revised:August 11, 2022 Click here to download the full text |
| Citation of this paper:WU Qiao-yan,YANG Quan-lin,WANG Chun-sheng,CHENG Lei-lei.The safety and efficacy of pannus removal or aortic valve re-replacement evaluated by transthoracic echocardiogram[J].Chinese Journal of Clinical Medicine,2022,29(5):753-759 |
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| Author Name | Affiliation | E-mail | | WU Qiao-yan | Department of Echocardiography, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China
Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai 200032, China | | | YANG Quan-lin | Department of Cardiac Surgery, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China
Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China | | | WANG Chun-sheng | Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China | | | CHENG Lei-lei | Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai 200032, China | cheng.leilei@zs-hospital.sh.cn |
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| Abstract:Objective To explore the safety and efficacy between the simple pannus removal and the repeat aortic valve replacement accounted of transthoracic echocardiogram (TTE) data. Methods From September 2019 to March 2022, 41 cases of the mechanical aortic valve obstruction from Zhongshan Hospital, Fudan University were confirmed pannus overgrowth underwent reoperation. Among them, 17 cases received the excision of pannus with preserving the prior implanted prosthesis (pannus removal, n=17) and 24 cases accepted the repeat aortic valve replacement (AVR, valve re-replacement, n=24),compared peroperative clinical outcomes and perioperative TTE data in two groups. Results There was no significant difference between procedures in mechanical aortic in aortic transvalvular peak velocity (Vmax), transvalvular peak velocity (PGmax), transvalvular mean pressure gradient (TMPG), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVSDD) and left ventricular ejection fraction (LVEF), tested before and after 1 week of surgery. The preoperative TEE data of two groups had reached the indications for surgery, and both postoperative TMPG was below 20 mmHg. Significant differences were acquired between procedures in cardiopulmonary bypass and aortic cross-clamp time (P<0.01). There was a moderate positive correlation between CPB and serum troponin T (cTnT, r=0.543, P<0.001),on the first postoperative day. White blood cells (WBC) of valve re-replacement on the first postoperative day was significantly higher than that in Pannus resection group (P<0.05). During postoperative hospitalization, 10 cases emerged complications (41.6%) in valve re-replacement group, including 2 severe multiorgan dysfunction and 4 deaths (16.7%), while only 4 cases (16.7%) had complications in the pannus removal group without perioperative death. Conclusion The perioperative clinical outcomes and TTE data show that pannus removal is a safe and effective procedure. TTE is the routine imaging method for screening of the function of mechanical aortic valve. |
| keywords:mechanical aortic valve obstruction pannus transthoracic echocardiogram pannus removal aortic valve re-replacement |
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