Mini-aortic surgery with percutaneous cannulation and rapid-deployment valve

Abstract

The combined use of rapid-deployment valves, percutaneous cardioplegia, and left heart venting is safe and effective and allows a significant reduction of the skin incision together with a significant reduction of intraoperative times without affecting hospital outcomes or hemodynamic performance of the prosthetic valves.

Rapid deployment or sutureless versus conventional bioprosthetic aortic valve replacement: A meta-analysis

“…The risk of the need for PPM insertion after AVR was drawn from 17 studies with 2435 patients [5][6][7][13][14][15][16][17][18][19][21][22][23][26][27][28][29] after the exclusion of 1 study that reported no patients with a PPM insertion. 20 The pooled analysis showed that the risk of PPM insertion was significantly higher in the RDAVR group than in the CAVR group (RR, 2.08; 95% CI, 1.49-2.90; I 2 ¼ 0%). The risk of PPM was also significant in pooled estimates from the adjusted results from 9 studies (Figure 4).…”

“…Therefore, a total of 21 studies were included in this review ( Figure E1). [4][5][6][7][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”

“…Twelve studies exclusively used the Perceval S (Sorin Group; Milan; Italy), 4,5,13,[15][16][17][21][22][23]25,27,28 whereas the Edwards Intuity valve (Edwards Lifescience Corp; Irvine, Calif) was used exclusively in 5 studies. 6,7,19,20,26 A minimally invasive approach through mini-sternotomies or right anterior thoracotomies were more frequently performed in the RDAVR group than in the CAVR group (69.1% vs 37.7%). Clinical follow-up was reported in 12 studies [4][5][6][7]14,[16][17][18][19]21,22,28 up to an average follow-up duration of 2.9 years (Table 1).…”

“…Of the 19 NRSs, 11 studies 4,6,7,13,15,18,[24][25][26][27][28] were graded as overall severe ROB because of the presence of confounding biases, because the patients' baseline characteristics were not balanced across groups and appropriate adjustments for confounding factors were not used. The other 8 studies used propensity score matching 14,16,17,20,21,23,29 or 1:1 matching 5 and were rated overall moderate ROB, because the baseline characteristics were similar between groups, and the other ROB items were graded low (Table E1).…”

“…A pooled analysis of any PVL from 12 studies with 2377 patients [4][5][6][7]13,15,[17][18][19][20][21]28 showed a significantly higher risk of any PVL in the RDAVR group than in the CAVR group (RR, 2.32; 95% CI, 1.53-3.51; I 2 ¼ 25.6%; Figure 3). The risks of any PVL were insignificant when the pooled estimates were drawn from the adjusted results in 5 studies (RR, 1.25; 95% CI, 0.70-2.23; I 2 ¼ 0%; Figure 3).…”