Abstract
Aortic valve replacement remains the most common procedure in heart valve surgery. The existing common methods
of prosthesis implantation techniques are associated with such complications as “prosthesis-patient” mismatch
and paraprosthetic regurgitation. The last, in turn, are inseparably associated with increased frequency of hospital
mortality and mortality in redo (11–25%). They are also the cause of decreased quality of life after surgical intervention.
Various methods of aortic valve replacement are used throughout the world to reduce the risk of these complications.
Also, the improvement of approaches to surgical correction of aortic valve disease continues. In this
regard, there is a need to study the results of the introduction of new methods of correction of aortic valve diseases.
Keywords: prosthesis-related complications; paraprosthesis fistula; “prosthesis-patient” mismatch; fibrosis ring
dilation; narrow fibrosis ring.
References
- Leopold J.A. Cellular mechanisms of aortic valve calcification.
Circ. Cardiovasc. Interv. 2012; 5 (4): 605–14.
DOI: 10.1161/CIRCINTERVENTIONS.112.971028
- Burakovskiy V.I., Boсkeria L.A. (Eds.) Cardiovascularsurgery. Moscow: Meditsina; 1989: 752; 383–90(in Russ.).
- Lung B., Vahanian A. Epidemiology of acquired valvular
heart disease. Can. J. Сardiol. 2014; 30 (9): 962–70. DOI: 10.1016/j.cjca.2014.03.022
- Manning W.J. Asymptomatic aortic stenosis in the elderly:
a clinical review. JAMA. 2013; 310 (14): 1490–7. DOI: 10.1001/jama.2013.279194
- Stewart B.F., Siscovick D., Lind B.K., Gardin J.M.,
Gottdiener J.S., Smith V.E. et al. Clinical factors associated
with calcific aortic valve disease. Cardiovascular
Health Study. J. Am. Coll. Cardiol. 1997; 29 (3): 630–4.
DOI: 10.1016/S0735-1097(96)00563-3
- Gummert J.F., Funkat A.K., Beckmann A., Ernst M,
Hekmat K. Cardiac surgery in Germany during 2010:
A report on behalf of the German Society for Thoracic
and Cardiovascular Surgery. Thorac. Cardiovasc. Surg.
2011; 59 (5): 259–67. DOI: 10.1055/s-0030-1271191
- Latson L.A. Transcatheter closure of PVL leaks after surgical
mitral and aortic valve replacements. J. Exp. Rev.
Cardiovasc. Ther. 2009; 7 (5): 507–14. DOI: 10.1586/erc.09.21
- Matsuyama K., Matsumoto M., Sugita T., Nishizawa J.,
Kawansihi Y., Uehara K. Long-tern results of reoperative
mitral valve surgery in patients with rheumatic disease.
Ann. Thorac. Surg. 2003; 76 (6): 1939–43. DOI: 10.1016/S0003-4975(03)01061-0
- Korteland N.M., Etnel J.R.G., Arabkhani B., Mokhles
M.M., Mohamad A., Roos-Hesselink J.W. et al.
Mechanical aortic valve replacement in non-elderly
adults: meta-analysis and microsimulation. Eur. Heart J.
2017; 38 (45): 3370–7. DOI: 10.1093/eurheartj/ehx199
- Aydin E., Yapici F. A retrospective analysis of factors
influencing re-operation in patients undergoing mechanical
valve replacement. Cardiovasc. J. Afr. 2013; 24 (7):
251–4. DOI: 10.5830/CVJA-2013-044
- Pomerantseff M.A., Steffen S.P., del Almeida Branda~
o C.M., Lapenna G.A., Tarasoutchi F., Jatene F.B.
Surgical thrombectomy of mechanical valve thrombosis.
J. Heart Valve Dis. 2015; 24 (6): 780–4. http://europepmc.org/abstract/med/ 27997787
- Luk A., Kim M.L., Ross H.J., Rao V., David T.E.,
Butany J. Native and prosthetic valve infective endocarditis:
clinicopathologic correlation and review of the
literature. Malaysian J. Pathol. 2014; 36 (2): 71–81.
- Nottin R., Al-Attar N., Ramadan R., Azmoun A.,
Therasse A., Kortas Ch. et al. Aortic valve translocation
for severe prosthetic valve endocarditis: Early results and
long-term follow-up. Ann. Thorac. Surg. 2005; 79:
1486–90. DOI: 10.1016/j.athoracsur.2004.10.047
- Matsuyama K., Matsumoto M., Sugita T., Nishizawa J.,
Kawanisihi Y., Uehara K. Long-term results of reoperative
mitral valve surgery in patients with rheumatic disease.
Ann. Thorac. Surg. 2003; 76: 1939–43. DOI: 10.1016/S0003-4975(03)01061-0
- Habets J., Budde R.P., Symersky P., van den Brink R.B.,
de Mol B.A., Mali W.P. et al. Nature reviews. Cardiology.
2011; 8 (8): 466–78. DOI: 10.1038/nrcardio.2011.71
- Alonso-Briales J.H., Mun~oz-García A.J., Jiménez-
Navarro M.F., Domínguez-Franco A.J., Melero-Tejedor
J.M., Rodríguez-Bailón I. et al. Closure of perivalvular
leaks using an Amplatzer occluder. Rev. Esp. Cardiol.
2009; 62 (04): 442–6. DOI: 10.1016/S1885-5857(09)71672-X
- Skopin I.I., Mironenko V.A., Aliev Sh.M. Surgical treat-ment of fistulas of prosthetic heart valves of non-infec-tious genesis. Russian Journal of Thoracic andCardiovascular Surgery. 2006; 4: 14–7 (in Russ.).
- Skopin I.I., Sal'nikov A.V., Mironenko V.A. Reopera-tions for mechanical heart valves obstructions. RussianJournal of Thoracic and Cardiovascular Surgery. 2006; 2:9–12 (in Russ.)
- Genoni M., Franzen D., Vogt P., Seifert B., Jenni R.,
Künzli A. et al. Paravalvular leakage after mitral valve
replacement: improved long-term survival with aggressive
surgery? Eur. J. Cardiothorac. Surg. 2000; 17 (1): 14–9.
DOI: 10.1016/S1010-7940(99)00358-9
- De Cicco G., Lorusso R., Colli A., Nicolini F., Fragnito
C., Grimaldi T. et al. Aortic valve periprosthetic leakage:
anatomic observations and surgical results. Ann.
Thorac. Surg. 2005; 79 (5): 1480–5. DOI: 10.1016/j.athoracsur.2004.11.058
- De Cicco G., Russo C., Moreo A., Beghi C., Fucci C.,
Gerometta P., Lorusso R. Mitral valve periprosthetic
leakage: anatomical observations in 135 patients from
a multicentre study. Eur. J. Cardiothorac. Surg. 2006;
30 (1): 887–91. DOI: 10.1016/j.ejcts.2006.09.019
- Alekyan B.G., Golukhova E.Z., Pursanov M.G.,Mashina T.V., Chebotareva G.E., Nekhay Yu.A. et al.Closure of paraprosthetic fistula of the mitral valve pros-thesis using the occluder: a literary reference and a de-scription of the clinical case. Creative Cardiology. 2011; 1:101–8 (in Russ.)
- Bhindi R., Bull S., Schrale R.G., Wilson N., Ormerod
O.J. Surgery insight: percutaneous treatment of prosthetic
paravalvular leaks. Nat. Clin. Pract. Cardiovasc.
Med. 2008; 5 (3): 140–7. DOI: 10.1038/ncpcardio1112
- Pate G.E., Al Zubaidi A., Chandavimol M., Thompson
C.R., Munt B.I., Webb J.G. Percutaneous closure of
prosthetic paravalvular leaks: case series and review.
Catheter. Cardiovasc. Interv. 2006; 68 (4): 528–33. DOI: 10.1002/ccd.20795
- Dávila-Román V.G., Waggoner A.D., Kennard E.D.,
Holubkov R., Jamieson W.R., Englberger L. et al.
Prevalence and severity of paravalvular regurgitation in
the Artificial Valve Endocarditis Reduction Trial
(AVERT) echocardiographic study. J. Am. Coll. Cardiol.
2004; 44 (7): 1467–72. DOI: 10.1016/j.jacc.2003.12.060
- Pham N., Zaitoun H., Mohammed T.L., DeLaPena-
Almaguer E., Martinez F., Novaro G. M. et al. Complications
of aortic valve surgery: manifestations at CT and
MR imaging. RadioGraphics. 2012; 32 (7): 1873–92.
DOI: 10.1148/rg.327115735
- Genoni M., Franzen D., Tavakoli R., Seiffert B.,
Graves K., Jenni R., Turina M. Does the morphology of
mitral paravalvular leaks influence symptoms and hemolysis?
J. Heart Valve Dis. 2001; 10 (4): 426–30.
- O'Rourke D.J., Palac R.T., Malenka D.J., Marrin C.A.,
Arbuckle B.E., Plehn J.F. Outcome of mild periprostetic
regurgitation detected by intraoperative transesophageal
echocardiography. J. Am. Coll. Cardiol. 2001; 38 (1):
163–6. DOI: 10.1016/S0735-1097(01)01361-4
- Taramasso M., Maisano F., Denti P., Guidotti A., Sticchi
A., Pozzoli A. et al. Surgical treatment of paravalvular
leak: Long-term results in a single-center experience
(up to 14 years). J. Thorac. Cardiovasc. Surg. 2015;
149 (5): 1270–5. DOI: 10.1016/j.jtcvs.2014.12.041
- Smolka G., Ochała A., Jasiński M., Pysz P., Biernat J.,
Gasior Z. Percutaneous treatment of periprosthetic valve
leak in patients not suitable for reoperation. Kardiol. Pol.
2010; 68 (3): 369–73.
- Bairaktaris A., Haas N.A., Seifert D., Schaeffler R.,
Koertke H., Schenk S. et al. Pitfalls in catheter-based
interventions to treat paravalvular leaks. J. Thorac.
Cardiovasc. Surg. 2008; 136 (4): 1076–7. DOI: 10.1016/j.jtcvs.2007.08.084
- Merin O., Bitran D., Fink D., Asher E., Silberman Sh.
Mechanical valve obstruction caused by an occlusion
device. J. Thorac. Cardiovasc. Surg. 2007; 133 (3): 806–7.
DOI: 10.1016/j.jtcvs.2006.10.048
- Rahimtoola S.H. The problem of valve prosthesis-patient
mismatch. Circulation. 1978; 58: 20–4. DOI: 10.1161/01.CIR.58.1.20
- Dumesnil J.G., Yoganathan A.P. Valve prosthesis hemodynamics
and the problem of high transprosthetic pressure
gradients. Eur. J. Cardiothorac. Surg. 1992; 6 (Supp. 1):
S34–S38. DOI: 10.1016/1010-7940(92)90019-t
- Pibarot P., Dumesnil J.G. Patient-prosthesis mismatch
and the predictive use of indexed effective orifice area: is
it relevant? Card. Surg. Today. 2003; 1: 43–51.
- Pibarot P., Dumesnil J.G., Lemieux M., Cartier P.,
Métras J., Durand L.G. Impact of prosthesis-patient
mismatch on hemodynamic and symptomatic status,
morbidity, and mortality after aortic valve replacement
with a bioprosthetic heart valve. J. Heart Valve Dis. 1998;
7 (2): 211–8.
- Tasca G., Brunelli F., Cirillo M., Dalla Tomba M.,
Mhagna Z., Troise G. et al. Impact of valve prosthesispatient
mismatch on left ventricular mass regression following
aortic valve replacement. Ann. Thorac. Surg. 2005;
79 (2): 505–10. DOI: 10.1016/j.athoracsur.2004.04.042
- Bockeria L.A., Gazal B. “Prosthesis-patient mismatch”in patients with aortic valve prosthesis. Russian Journal ofSurgery. 2012; 2: 5–9 (in Russ.)
- Del Rizzo D.F., Abdoh A., Cartier P., Doty D., Westaby
S. Factors affecting left ventricular mass regression
after aortic valve replacement with stentless valves.
Semin. Thorac. Cardiovasc. Surg. 1999; 11 (4, Suppl. 1):
114–20.
- Tasca G., Brunelli F., Cirillo M., Amaducci A., Mhagna
Z., Troise G. et al. Mass regression in aortic stenosis
after valve replacement with small size pericardial bioprosthesis.
Ann. Thorac. Surg. 2003; 76 (4): 1107–13.
DOI: 10.1016/S0003-4975(03)00823-3
- Belov Yu.V., Charchyan E.R., Katkov A.I., Salagaev G.I.,Vinokurov I.A. The effect of a mismatch between thediameter of the prosthesis and the patient's body surfacearea on the long-term results of aortic valve replacement.Kardiologiya i Serdechno-Sosudistaya Khirurgiya (RussianJournal of Cardiology and Cardiovascular Surgery).2016;2: 46–51 (in Russ.). DOI: 10.17116/kardio20169246-51
- Tasca G., Brunelli F., Cirillo M., Dalla Tomba M.,
Mhagna Z., Troise G. et al. Impact of the improvement
of valve area achieved with aortic valve replacement on
the regression of left ventricular hypertrophy in patients
with pure aortic stenosis. Ann. Thorac. Surg. 2005; 79 (4):
1291–6. DOI: 10.1016/j.athoracsur.2004.09.002
- Gould K.L., Carabello B.A. Why angina in aortic stenosis
with normal coronary arteriograms? Circulation.
2003; 107: 3121–3. DOI: 10.1161/01.CIR.0000074243.02378.80
- Rajappan K., Rimoldi E.O., Dutka P.D., Ariff B.,
Pennell J.D., Sheridan J.D. et al. Mechanisms of coronary
microcirculatory dysfunction in patients with aortic
stenosis and angiographically normal coronary arteries.
Circulation. 2018; 105: 470–6. DOI: 10.1161/circ.105.4.470
- Rajappan K., Rimoldi O.E., Camici P.G., Bellenger
N.G., Pennell D.J., Sheridan D.J. Functional
changes in coronary microcirculation after valve replacement
in patients with aortic stenosis. Circulation. 2003;
107 (25): 3170–5. DOI: 10.1161/01.CIR.0000074211.28917.31
- Milano A.D., De Carlo M., Mecozzi G., D'Alfonso A.,
Scioti G., Nardi C. et al. Clinical outcome in patients
with 19-mm and 21-mm St. Jude aortic prostheses:
comparison at long-term follow-up. Ann. Thorac. Surg.
2002; 73 (1): 37–43. DOI: 10.1016/S0003-4975(01)03306-9
- Ruel M., Rubens F.D., Masters R.G., Pipe A.L., Bédard
P., Hendry P.J. et al. Late incidence and predictors
of persistent or recurrent heart failure in patients with
aortic prosthetic valves. J. Thorac. Cardiovasc. Surg.
2004; 127 (1): 149–59. DOI: 10.1016/j.jtcvs.2003.07.043
- Mohty-Echahidi D., Malouf J.F., Girard S.E.,
Schaff H.V., Grill D.E., Enriquez-Sarano M.E. et al.
The impact of prosthesis-patient mismatch on long-term
survival in patients with small St Jude Medical mechanical
prostheses in the aortic position. Circulation. 2006;
113: 420–6. DOI: 10.1161/CIRCULATIONAHA.105.546754
- Tasca G., Mhagna Z., Perotti S., Centurini P.B., Sabatini
T., Amaducci A. et al. Impact of prosthesis-patient
mismatch on cardiac events and mortality after aortic
valve replacement in patients with pure aortic stenosis.
Circulation. 2006; 113 (4): 570–6. DOI: 10.1161/CIRCULATIONAHA.105.587022
- Rao V., Jamieson W.R.E., Ivanov J., Susan Armstrong S.,
David T.E. Prosthesis-patient mismatch affects survival
following aortic valve replacement. Circulation. 2000; 102:
Iii-5–Iii-9. DOI: 10.1161/01.CIR.102.suppl_3.III-5
- Guo L., Zheng J., Chen L., Li R., Ma L., Ni Y., Zhao H.
Impact of prosthesis-patient mismatch on short-term
outcomes after aortic valve replacement: a retrospective
analysis in East China. J. Cardiothorac. Surg. 2017;
12 (1): 42. DOI: 10.1186/s13019-017-0596-2
- Hanayama N., Christakis G.T., Mallidi H.R.,
Joyner C.D., Fremes S.E., Morgan C.D. et al. Patient
prosthesis mismatch is rare after aortic valve replacement:
valve size may be irrelevant. Ann. Thorac. Surg.
2002; 73 (6): 1822–9. DOI: 10.1016/S0003-4975(02)03582-8
- Dayan V., Vignolo G., Soca G., Paganini J.J., Brusich
D., Pibarot P. Prosthesis-patient mismatch after aortic
valve replacement. JACC: Cardiovasc. Imaging. 2016;
9 (8): 924–33. DOI: 10.1016/j.jcmg.2015.10.026
- Nicks R., Cartmill T., Bernstein L. Hypoplasia of the
aortic root: the problem of the aortic valve replacement.
Thorax. 1970; 25 (3): 339–46.
- Kawachi Y., Tominaga R., Tokunaga K. Eleven-year follow-
up study of aortic or aorticmitral anulus-enlarging
procedure by Manouguian's technique J. Thorac.
Cardiovasc. Surg. 1992; 104 (5): 1259–63.
- Kitamura M., Satoh M., Hachida M., Endo M.,
Hashimoto A., Koyanagi H. Aortic valve replacement in
small aortic annulus with or without annular enlargement.
J. Heart Valve Dis. 1996; 5 (Suppl. 3): S289–93.
- Castro L.J., Arcidi J.M. Jr., Fisher A.L., Gaudiani V.A.
Routine anlargement of the small aortic root: a preventive
strategy to minimize mismatch. Ann. Thorac. Surg. 2002;
74 (1): 31–6. DOI: 10.1016/S0003-4975(02)03680-9
- Dhareshwar J., Sundt T.M., Dearani J.A., Schaff H.V.,
Cook D.J., Orszulak T.A. Aortic root enlargement: what
are the operative risks? J. Thorac. Cardiovasc. Surg. 2007;
134 (4): 916–24. DOI: 10.1016/j.jtcvs.2007.01.097
- De Pepo A.P., Zeitani J., Nardi P., Iaci G., Polisca P., De
Paulis R. et al. Small «functional» size after mechanical
aortic valve replacement: no risk in young to middle-age
patients. Ann. Thorac. Surg. 2005; 79 (6): 1915–20. DOI: 10.1016/j.athoracsur.2004.12.001
- Podzolkov V.P., Chiaureli M.R., Kokshenev I.V., Sam-sonov V.B., Danilov T.Yu., Nosachev A.M. et al. A newapproach to performing a Manougian–Seybold–Eptingin patients with congenital aortic valve defect. Children'sHeart and Vessels Diseases. 2011; 4: 35–42 (in Russ.).
About the authors
Firdavs I. Zakirov, Postgraduate; orcid.org/0000-0002-0846-186X
