Mitral Kapak Replasmanında Sütür Tekniklerinin Karşılaştırmalı Değerlendirilmesi: Klinik Sonuçlar Üzerindeki Etkisi

Year 2023, Volume: 33 Issue: 5, 532 - 535, 25.10.2023

Serkan Mola , Alp Yıldırım , Sabir Hasanzade , Gokay Denız , Burak Kasapoğlu

https://doi.org/10.54005/geneltip.1302812

Abstract

Amaç: Bu çalışmanın amacı mitral kapak replasmanında (MKR) aralıklı basit sütür tekniği ile pledgetli horizontal matriks sütür tekniğinin sonuçlarını paravalvüler kaçak ve enfektif endokardit açısından karşılaştırmaktır.
Yöntemler: 2019-2023 yılları arasında MKR uygulanan 422 hasta retrospektif olarak analiz edildi. Hastalar kullanılan sütür tekniğine göre iki gruba ayrıldı: grup B (basit sütür tekniği) ve grup P (pledgetli horizontal matriks sütür tekniği). Grupları dengelemek için eğilim skoru eşleştirmesi yapıldı ve karşılaştırmalı analiz için 62 vaka çifti elde edildi.
Bulgular: İntraoperatif mortalite izlenmedi ve kardiyopulmoner baypas süresi ve kros klemp süresi iki grup arasında anlamlı farklılık göstermedi. Toplam hastanede yatış süresi, hastane içi mortalite, serebrovasküler olaylar ve aritmiler açısından iki grup arasında anlamlı fark gözlenmedi. Ameliyat sonrası ekokardiyografide her iki grupta da minimal paravalvüler kaçak saptandı; B grubunda 4 hastada ve P grubunda 2 hastada ciddi olmayan kaçak gözlendi. Enfektif endokardit insidansı B grubunda 1 ve P grubunda 2 idi. Hemoliz göstergeleri istatistiksel olarak anlamlı olmasa da basit sütür tekniği grubunda daha yüksek ortalama değerler gösterdi.
Sonuç: Bu çalışma, aralıklı basit sütür tekniği ile pledgetli horizontal matriks sütür tekniği arasında paravalvüler kaçak ve enfektif endokardit insidansı açısından anlamlı bir fark olmadığını gösterdi. Her iki teknik de MKR'de güvenle kullanılabilir.

Keywords

enfektif endokardit, mitral kapak replasmanı, paravalvüler kaçak, sütür tekniği

Comparative Evaluation of Suture Techniques in Mitral Valve Replacement: Impact on Clinical Outcomes

Abstract

Background: This study aimed to compare the outcomes of mitral valve replacement (MVR) using the intermittent simple suture technique versus the horizontal matrix suture technique with pledgeted in terms of paravalvular leakage and infective endocarditis.
Methods: A retrospective analysis was conducted on 422 patients who underwent MVR between 2019 and 2023. Patients were divided into two groups based on the suture technique used: group B (simple suture technique) and group P (horizontal matrix suture technique with pledgeted). Propensity score matching was performed to balance the groups, resulting in 62 case pairs for comparative analysis.
Results: There were no intraoperative mortalities, and the duration of cardiopulmonary bypass and cross-clamp time did not significantly differ between the two groups. No significant differences were observed in terms of total hospitalization time, early mortality, cerebrovascular events, and arrhythmias. Postoperative echocardiography revealed minimal paravalvular leakage in both groups, with non-serious leakage observed in 4 patients in group B and 2 patients in group P. The incidence of infective endocarditis was 1 in group B and 2 in group P. Hemolysis indicators showed higher mean values in the simple suture technique group, although not statistically significant.
Conclusions: The study findings suggest that there is no significant difference in the incidence of paravalvular leak and infective endocarditis between the intermittent simple suture technique and the horizontal matrix suture technique with pledgeted. Both techniques can be safely employed in MVR.

Keywords

infective endocarditis, mitral valve replacement, paravalvular leak, suture technique

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