Meet Inspiring Speakers and Experts at our 3000+ Global Conference Series Events with over 1000+ Conferences, 1000+ Symposiums
and 1000+ Workshops on Medical, Pharma, Engineering, Science, Technology and Business.

Explore and learn more about Conference Series : World's leading Event Organizer

Back

Enrico Ferrari

Enrico Ferrari

University Hospital of Lausanne, Switzerland

Title: Sapien 3 aortic valve implantation in conventional reoperative aortic valve surgery to prevent patient-prosthesis mismatch in overweight patients

Biography

Biography: Enrico Ferrari

Abstract

The aim of this brief report is to show technical details and feasibility of balloon-expandable stent-valve implantation in aortic position during conventional redo open-heart surgery in overweight patients with small-sized mechanical aortic prosthesis and patient-prosthesis mismatch.

Methods and results
Two consecutive symptomatic overweight patients (BMI of 31 and 38) with small mechanical aortic prosthesis (a 4 year-old 21mm Hancock II valve and a 29 year-old 23mm Duromedic valve), increased gradients (59/31mmHg and 74/44mmHg) and reduced indexed effective orifice area (0.50cm2/m2 and 0.43cm2/m2) were treated successfully with surgical implantation of two 26mm balloon-expandable SapienTM 3 valves during redo procedures. Under full sternotomy, cardiopulmonary bypass and cardioplegic arrest the stent-valves were implanted under direct view through the aortotomy and after mechanical valves removal. In one patient, a concomitant regurgitant mitral valve was replaced with a standard bioprosthesis. Aortic cross clamp times were 162 and 126 minutes; cardiopulmonary bypass times were 178 and 180 minutes; total surgical times were 360 and 318 minutes. At discharge, the echocardiographic control showed transvalvular peak and mean gradients of 13/9mmHg and 23/13mmHg, and indexed effective orifice areas of 0.64cm2/m2 and 1.08cm2/m2. The 3-month echocardiographic control showed transvalvular peak and mean gradients of 18/9mmHg and 19/11mmHg, and indexed effective orifice areas of 0.78cm2/m2 and 0.84cm2/m2, with improved symptoms.

Conclusion
Balloon-expandable stent-valve implantation during redo open-heart surgery is feasible and safe and prevents patient-prosthesis mismatch in overweight and obese patients. Moreover, in case of stent-valve degeneration this approach allows for additional valve-in-valve procedures with big-size stent-valves and prevents high-risk re-redo surgery