Continuous Suture Technique for Aortic Valve Replacement in Patients with Severe Aortic Valve Stenosis

Minoru Matsuhama

Mohd. Azhari Yakub, FRCS

（Department of Cardiovascular Surgery, Dai-ni Okamoto General Hospital＊, Uji, Japan, and Department of Cardiothoracic Surgery, National Heart Institute＊＊, Kuala Lumpur, Malaysia）

Objective:The aim of the present study is to show the continuous suture technique in which the aortic valve replacement can be safely performed to insert prosthetic valves of an appropriate size in patients with aortic stenosis associated with a small annulus. Patients and Methods:Thirteen patients with severe aortic valve stenosis（aortic valve area ＜1.0cm2）underwent aortic valve replacement with the continuous suture technique using three 2/0 non-absorbable monofilament polypropylene sutures. Transthoracic echocardiogram was performed before and after surgery in all patients to determine how large a prosthetic valve could be used compared to the preoperative annular size. Results:The mean size of the prosthetic valve implanted was 23.3mm, while the preoperative mean value of aortic annulus was 21.7mm. The 19mm size prosthetic valves were never used even when the preoperative aortic annular diameter was less than 19mm（in 2 patients). The duration of procedure time was adequate and the post-operative echocardiography showed excellent results with good prosthetic valve function and no adverse events. Conclusions:Using our continuous suture technique, prosthetic valves of an appropriate size can be safely and effectively inserted at an aortic position in patients with severe aortic stenosis.

 

Jpn. J. Cardiovasc. Surg. 45:10-15（2016）

Keywords：aortic valve replacement;continuous suture technique;paravalvular leakage;minimally invasive;prosthesis-patient mismatch