We present a modified implantation technique of the Perceval~? sutureless aortic valve(LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. Both limbs ...We present a modified implantation technique of the Perceval~? sutureless aortic valve(LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. Both limbs of each guiding suture are pulled through an elastic tube, which is fixed with a Pean clamp, which tightens the sutures and fixes the prosthesis to the aortic annulus during valve deployment. This method proved safe and useful in over 120 cases. Valve implantation was facilitated and the need for manipulation by the assistant or the nurse was eliminated.展开更多
Objectives: Thrombocytopenia has been reported following implantation of Perceval suture-less aortic valve. However, the time course of thrombocytopenia and platelet recovery is unknown. In addition, the effect of thr...Objectives: Thrombocytopenia has been reported following implantation of Perceval suture-less aortic valve. However, the time course of thrombocytopenia and platelet recovery is unknown. In addition, the effect of thrombocytopenia on post-operative outcome is unknown. We sought to study this observation and correlate that with short-term outcome. Methods: This is a retrospective review of a prospectively collected database over a 3-year period of all isolated aortic valve replacements (70 patients) using bioprosthetic valves (sutured Magna and suture-less Perceval). All preoperative, intraoperative and postoperative variables were collected and analyzed. Platelets count and mean platelet volumes were collected and analyzed in respect to the type of valve used and their time course. Results: The cohort consisted of 70 consecutive patients of which 42 underwent Perceval suture-less valve (group Perceval) and 28 underwent bioprosthetic sutured valve (group Magna). There was no difference in platelets count and mean platelet volume at baseline. However, Perceval group had significant drop in platelet count from day 1 to day 3 post-operatively, followed by a gradual increase in platelet count until discharge. Mean platelet volume, however, was not different between the two types of valves. Postoperative outcomes were similar in the two groups with exception of intensive care and a hospital stay which were significantly shorter in Perceval group. Conclusion: Thrombocytopenia following Perceval suture-less valve is observed from day 1 postoperatively and it is a transient phenomenon. It does not correlate with worse clinical outcomes postoperatively. Larger studies are needed to elucidate the mechanism and its impact.展开更多
文摘We present a modified implantation technique of the Perceval~? sutureless aortic valve(LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. Both limbs of each guiding suture are pulled through an elastic tube, which is fixed with a Pean clamp, which tightens the sutures and fixes the prosthesis to the aortic annulus during valve deployment. This method proved safe and useful in over 120 cases. Valve implantation was facilitated and the need for manipulation by the assistant or the nurse was eliminated.
文摘Objectives: Thrombocytopenia has been reported following implantation of Perceval suture-less aortic valve. However, the time course of thrombocytopenia and platelet recovery is unknown. In addition, the effect of thrombocytopenia on post-operative outcome is unknown. We sought to study this observation and correlate that with short-term outcome. Methods: This is a retrospective review of a prospectively collected database over a 3-year period of all isolated aortic valve replacements (70 patients) using bioprosthetic valves (sutured Magna and suture-less Perceval). All preoperative, intraoperative and postoperative variables were collected and analyzed. Platelets count and mean platelet volumes were collected and analyzed in respect to the type of valve used and their time course. Results: The cohort consisted of 70 consecutive patients of which 42 underwent Perceval suture-less valve (group Perceval) and 28 underwent bioprosthetic sutured valve (group Magna). There was no difference in platelets count and mean platelet volume at baseline. However, Perceval group had significant drop in platelet count from day 1 to day 3 post-operatively, followed by a gradual increase in platelet count until discharge. Mean platelet volume, however, was not different between the two types of valves. Postoperative outcomes were similar in the two groups with exception of intensive care and a hospital stay which were significantly shorter in Perceval group. Conclusion: Thrombocytopenia following Perceval suture-less valve is observed from day 1 postoperatively and it is a transient phenomenon. It does not correlate with worse clinical outcomes postoperatively. Larger studies are needed to elucidate the mechanism and its impact.
