Usporedba različitih vrsta mehaničkih mitralnih zalistaka

master's thesis

• Title (english): Comparison between different types of mechanical mitral valves
• Author: Luka Žurić
• Mentor: Igor Rudež (mentor)
• Committee member: Davor Mijatović (predsjednik povjerenstva)
• Committee member: Anko Antabak (član povjerenstva)
• Committee member: Igor Rudež (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Materijali i tehnike zamjene mitralnog zaliska usavršavaju se s namjerom postizanja hemodinamskih svojstava prirodne valvule. Zadnji u nizu inovativnih zalistaka je On-X Conform-X. U ovom radu uspoređuju se dvije skupine bolesnika (podijeljene ovisno o vrsti mehaničkog zaliska) analizom hemodinamskih parametara nakon ugradnje. Provedeno je opservacijsko, retrospektivno, kohortno istraživanje na uzorku od 107 pacijenata koji su podvrgnuti operaciji zamjene mitralnog zaliska u razdoblju od 2017. do 2023. godine na Odjelu za kardijalnu i transplantacijsku kirurgiju Kliničke bolnice Dubrava. Srednji transmitralni gradijenti tlaka bili su identični u obje skupine pacijenata (5.65 ± 1.95 mmHg u On-X skupini, te 5.65 ± 2.86 mmHg u skupini zalistaka adaptiranih prema veličini mitralnog prstena). Nadalje, vršni gradijenti tlaka i maksimalna brzina protoka, bili su nešto niži u skupini On-X zalistaka u usporedbi s drugom skupinom (13.27 ± 3.69 mmHg i 1.80 ± 0.29 m/s prema 13.86 ± 5.43 mmHg i 1.86 ± 0.36 m/s). Efektivna površina ušća također je bila nešto manja u skupini On-X zalistaka sa srednjom vrijednosti površine od 2.53 ± 0.61 cm2 u usporedbi s istim parametrom skupine adaptiranih zalistaka u kojoj je iznosio 2.82 ± 0.77 cm2.. Posljedično tomu, učestalost nesrazmjera efektivne površine ušća i površine tijela pacijenta (PPM-a) također je viša u skupini On-X zalistaka s 32.2% naprema 25% u skupini adaptiranih zalistaka. Naposljetku, važno je naznačiti kako niti jedna od navedenih razlika nije statistički značajna. Temeljem rezultata ove studije jasno je kako su hemodinamska svojstava On-X Conform-X zaliska podjednaka svojstvima mehaničkih mitralnih zalistaka tvrtki Saint Jude Medical, Carbomedics, te Carpentier.

Abstract (english)

The materials and techniques of mitral valve replacement are being continually improved in the hope of achieving hemodynamic properties of a natural valve. The latest inovation in this field of cardiac surgery is the On-X Conform-X mitral valve. In this study we compared two groups of patients (depending on the type of mechanical mitral valve used) by analysing their postoperative hemodynamic parameters. A retrospective, cohort, observational study was performed on a group of 107 patients who underwent mitral valve replacement surgery at the Department for Cardiac and Transplant Surgery, University Hospital Dubrava. Transmitral mean pressure gradients were identical in both groups of patients (5.65 ± 1.95 mmHg in On X valve group and 5.65 ± 2.86 in size-adjusted valves group). Furthermore, peak pressure gradients, as well as the peak flow velocity were on slightly lower in On-X group, than in size adjusted group (13.27 ± 3.69 mmHg and 1.80 ± 0.29 m/s versus 13.86 ± 5.43 mmHg and 1.86 ± 0.36 m/s, respectively). Effective orifice area was also slighty smaller in On-X group measuring 2.53 ± 0.61 cm2 compared to 2.82 ± 0.77 cm2 in the other group. Consequently, the incidence of patient-prosthesis mismatch was also higher in On-X valve group with 32.3% as opposed to 25% in size-adjusted group. However, none of these differences were of statistical significance. Based on these results, it is evident that hemodynamic properties of On-X Conform-X valve match those of other available mechanical mitral valves produced by Saint Jude Medical, Carbomedics and Carpentier.

• Keywords: zamjena mitralnog zaliska; mehanička proteza; On-X; transmitralni gradijent tlaka
• Keywords (english): mitral valve replacement; mechanical prosthesis; On-X; transmitral pressure gradient
• Language: croatian
• URN:NBN: urn:nbn:hr:105:603328
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-18 08:54:10