5 research outputs found
Continuous or interrupted pledgeted suture technique in stented bioprosthetic aortic valve replacement:a comparison of in-hospital outcomes
Get PDFBackground: There is ambiguity in the literature regarding the continuous suture technique (CST) for aortic valve replacement (AVR). At our center, there has been a gradual shift towards CST over the interrupted pledgeted technique (IPT). This study aims at comparing outcomes for both techniques. Methods: We performed a retrospective analysis of a single-center study of patients undergoing AVR between January 2011 and July 2020. Patients were divided into two groups: Continuous suture technique and interrupted pledget-reinforced sutures. The pre-operative and In-hospital clinical characteristics and echocardiographic hemodynamics (i.e. transvalvular gradients and paravalvular leakage) were compared between CST and IPT. Results: We compared 791 patients with CST to 568 patients with IPT (median age: 73 and 74 years, respectively, p = 0.02). In CST there were 35% concomitant procedure vs. 31% in IPT (p = 0.16). Early mortality was 3.2% in CST versus 4.8% in IPT (p = 0.15), and a second cross-clamp due to a paravalvular-leak in 0.5% vs. 1.2%, respectively (p = 0.22). The CST was not associated with new-onset conduction-blocks mandating pacemaker implants(OR 1.07, 95% CI 0.54–2.14; P = 0.85). The postoperative gradients on echocardiography were lower in CST compared to IPT, especially in smaller annuli (peak gradients: 15.7mmHg vs. 20.5mmHg, in valve size < 23 mm, p < 0.001). Conclusions: The continuous suture technique was associated with lower postoperative gradients and shorter cross-clamp time compared to interrupted pledgeted technique. Differences in paravalvular leaks were non-significant, although slightly less in the continuous suture technique. There were no further differences in valve-related complications. Hence, continues suture technique is safe, with better hemodynamics compared to the interrupted pledgeted technique. This may be of clinical importance, especially in smaller size annular size.</p
Continuous or interrupted pledgeted suture technique in stented bioprosthetic aortic valve replacement:a comparison of in-hospital outcomes
Get PDFBackground: There is ambiguity in the literature regarding the continuous suture technique (CST) for aortic valve replacement (AVR). At our center, there has been a gradual shift towards CST over the interrupted pledgeted technique (IPT). This study aims at comparing outcomes for both techniques. Methods: We performed a retrospective analysis of a single-center study of patients undergoing AVR between January 2011 and July 2020. Patients were divided into two groups: Continuous suture technique and interrupted pledget-reinforced sutures. The pre-operative and In-hospital clinical characteristics and echocardiographic hemodynamics (i.e. transvalvular gradients and paravalvular leakage) were compared between CST and IPT. Results: We compared 791 patients with CST to 568 patients with IPT (median age: 73 and 74 years, respectively, p = 0.02). In CST there were 35% concomitant procedure vs. 31% in IPT (p = 0.16). Early mortality was 3.2% in CST versus 4.8% in IPT (p = 0.15), and a second cross-clamp due to a paravalvular-leak in 0.5% vs. 1.2%, respectively (p = 0.22). The CST was not associated with new-onset conduction-blocks mandating pacemaker implants(OR 1.07, 95% CI 0.54–2.14; P = 0.85). The postoperative gradients on echocardiography were lower in CST compared to IPT, especially in smaller annuli (peak gradients: 15.7mmHg vs. 20.5mmHg, in valve size < 23 mm, p < 0.001). Conclusions: The continuous suture technique was associated with lower postoperative gradients and shorter cross-clamp time compared to interrupted pledgeted technique. Differences in paravalvular leaks were non-significant, although slightly less in the continuous suture technique. There were no further differences in valve-related complications. Hence, continues suture technique is safe, with better hemodynamics compared to the interrupted pledgeted technique. This may be of clinical importance, especially in smaller size annular size.</p
The Sao Tomé deep-sea turbidite system (Southern Brazil Basin): Cenozoic seismic stratigraphy and sedimentary processes
No full textInternational audienceThe Sao Tomé deep-sea turbidite system, elongated parallel to the rise of the south Brazilian continental margin, was first interpreted as a channel-levee system resulting from contour-current activity. Study of new seismic data permits the proposal of a stratigraphy for the system and a new interpretation of depositional processes. Three major depositional units have been recognized that are separated by major erosive discontinuities. The basal unit seems to be Paleocene to lower or middle Eocene, and the second one, subdivided into two subunits, is probably upper Oligocene to middle Miocene. Both units show superimposed north-to-south-channelized turbidite systems, with supply provided directly from a channel network that crosses the upper margin in the north. The third unit is upper Miocene(?) to Pliocene or Quaternary and is still under predominantly gravity processes: turbidite processes in the lower and upper subunits, and major mass-flow processes in the median subunit. The sediment sources are located either in the north or in the south, with sediment provided by major deep-sea channels. The base of the upper subunit is well marked by an erosive discontinuity (late Pliocene or Pliocene-Quaternary boundary). Impact of the contour currents is mainly recorded as widespread erosive surfaces (seismic discontinuities) correlated to global hydrological events and transparent or wavy deposits. Because this system contains a significant amount of upper Quaternary sands, it suggests the occurrence of petroleum reservoirs along the rise and the Sao Paulo Plateau in the lower continental slope
