Open transaortic implantation of “Medlab-KT” prosthesis

Bazylev V.V., Voevodin A.B., Slastin Ya.S., Karnakhin V.A.

Federal Centre of Cardiovascular Surgery of the RF Ministry of Public Health, Penza, Russia

Objective. The study was aimed at comparing the immediate clinical and haemodynamic results of open implantation of the balloon-expandable aortic prosthesis “MedLab-KT” with the respective parameters of standard replacement of the aortic valve by a mechanical prosthesis in high-risk surgical patients.

Materials and methods. We analysed a total of 209 cases of prosthetic repair of the aortic valve. The Study Group comprised 28 patients subjected to open implantation of the “MedLab-KT” prosthesis in conditions of extracorporeal circulation and myocardial ischaemia and belonging to a high-surgical risk cohort. The Comparison Group included 181 patients who endured standard open prosthetic repair of the aortic valve with a mechanical prosthesis. Using the ppropensity score matching method, we selected 28 patients from the Comparison Group, followed by assessing the incidence of adverse clinical events and haemodynamic parameters of the aortic valve prosthesis at the in-hospital stage.

Results. There were no lethal outcomes in the study group, with one in the group of standard aortic valve repair – 3.6%. The mean operative time in the Study and Comparison Group patients amounted to 121.5±51.2 and 274.2±55.3 min (p=0.04), the duration of extracorporeal circulation to 56.1±19.5 and 119.9±23.4 min (p=0.04), that of myocardial ischaemia to 38.4±17.1 and 96.7±20.8 (p=0.03), respectively. The mean gradient on the aortic valve in the “MedLab-KT” group was less (7.5±3.2 mm Hg) than in those of the second group (9±3.5 mm Hg), with no statistically significant differences in the parameters revealed (p=0.096). All patients of the study group were discharged from hospital in a satisfactory condition, with the haemodynamic result of the operation regarded as satisfactory.

Conclusions. Comparing the main clinical characteristics and haemodynamic parameters in the groups of «MedLab-KT» and aortic valve prosthetic repair at the hospital stage revealed no statistically significant differences. Open implantation of the “MedLab-KT” prosthesis proved safe and effective.

KEY WORDS: transcatheter aortic valve replacement, MedLab-KT, aortic valve prosthetic repair, high-risk surgical patient, aortic valve stenosis.

p. 120-124

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