Minimal access rapid deployment aortic valve replacement: Initial single-center experience and 12-month outcomes

Schlömicher, Markus; Haldenwang, Peter Lukas; Moustafine, Vadim; Bechtel, Matthias; Strauch, Justus

doi:10.1016/j.jtcvs.2014.09.118

Cited by 37 publications

(47 citation statements)

References 29 publications

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“…77 years; mean additive EuroSCORE 6.8) with more than 46% of patients undergoing a combined procedure with CABG, an acceptable all-cause 30-day mortality (3.2%) and postoperative complication rate that is comparable to previous studies that included patients with similar or lower risk profile using the Perceval S [4,7,10] or Intuity RDV [5,8,16,17]. For the Perceval RDV, the largest multicenter experience reported a 30-day mortality rate of 3.4% for a total of 731 patients [10].…”

Section: Commentsupporting

confidence: 63%

Direct Comparison of the Edwards Intuity Elite and Sorin Perceval S Rapid Deployment Aortic Valves

Liakopoulos

Gerfer

Weider

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 63%

Direct Comparison of the Edwards Intuity Elite and Sorin Perceval S Rapid Deployment Aortic Valves

Liakopoulos

Gerfer

Weider

et al. 2018

The Annals of Thoracic Surgery

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“…Only Schlömicher and coworker demonstrated a markedly reduced aortic cross clamp time for the Edwards Intuity rapid deployment valve (26 ± 7 min.) in hemisternotomy AVR [2]. A randomized comparison between patients undergoing minimally invasive AVR with rapid deployment valve systems and standard stented biological valves has not been reported yet.…”

Section: Discussionmentioning

confidence: 99%

“…One reason for the reluctance to adopt minimal invasive technique might be a presumed longer aortic cross clamp and cardiopulmonary bypass time with negative effects for the patient. The data from recent publications clearly demonstrate the safety and effectiveness of rapid deployment valves, showing reduced aortic cross clamp and cardiopulmonary bypass time compared to standard stented biological valves [2, 17, 18]. Today only two rapid deployment valve systems are on the market, the Perceval valve (Sorin Group; Milan; Italy) on the one hand and the Edwards Intuity rapid deployment valve system (Edwards Lifescience Corp; Irvine, Calif; U.S.A.) on the other hand.…”

Section: Introductionmentioning

confidence: 99%

Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy

Bening

Hamouda

Oezkur

et al. 2017

J Cardiothorac Surg

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BackgroundThere is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT.MethodsSixty-eight patients (mean age 76 ± 6 years, 32% females) underwent RAT-AVR between 9/2013 and 7/2015. According to the valve type implanted the patients were divided into two groups. In 43 patients (R-group; mean age 74.1 ± 6.6 years) a rapid deployment valve system (Edwards Intuity, Edwards Lifesciences Corp; Irvine, Calif) and in 25 patients (C-group; mean age 74.2 ± 6.6 years) a conventional stented biological aortic valve was implanted.ResultsAortic cross-clamp (42.1 ± 12 min vs. 68.3 ± 20.3 min; p < 0.001) and bypass time (80.4 ± 39.3 min vs. 106.6 ± 23.2 min; p = 0.001) were shorter in the rapid deployment group (R-group). We observed no differences in clinical outcome. Postoperative gradients (R-group: max gradient, 14.3 ± 8 mmHg vs. 15.5 ± 5 mmHg (C-group), mean gradient, 9.2 ± 1.7 mmHg (R-group) vs. 9.1 ± 2.3 mmHg (C-group) revealed no differences. However, larger prostheses were implanted in C-group (25 mm; IQR 23–27 mm vs. 23 mm; IQR 21–25; p = 0.009).ConclusionsOur data suggest that the rapid deployment aortic valve system reduced cross clamp and bypass time in patients undergoing RAT-AVR with similar hemodynamics as with larger size stented prosthesis. However, larger studies and long-term follow-up are mandatory to confirm our findings.

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“…However, there are also studies that contradict this finding, presenting results showing that MIS-AVR has a shorter operative time [20,21]. However, sutureless valves reduce the time and complications of MIS-AVR, and are thus a good option for MIS-AVR implants [12,13,21,22]. …”

Section: Discussionmentioning

confidence: 99%

“…To further reduce operative time, the rapid deployment system (RDAVR) was introduced and proved to be suitable for MIS-AVR [10–13]. Furthermore, it may be a suitable technique for high-risk patients who are obliged to undergo surgery of the aortic valve due to conditions such as endocarditis [14].…”

Section: Introductionmentioning

confidence: 99%

Initial Experience with Aortic Valve Replacement via a Minimally Invasive Approach: A Comparison of Stented, Stentless and Sutureless Valves

et al. 2017

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BackgroundThis study aimed to compare the short-term outcomes of MIS-AVR among 3 different types of biological heart valves.Material/MethodsComplete data were obtained from 79 patients who underwent MIS-AVR between January 2010 and June 2015. Patients were divided into 3 groups: 27 patients (group A) received Medtronic 3f® (Medtronic Inc., Fridley, MN, USA), 36 patients (group B) received DokimosPlus® (LabCor Laboratórios Ltda., Belo Horizonte, Brazil) and 16 patients (group C) received Perceval® (Sorin Biomedica Cardio S.r.l., Saluggia VC, Italy) valves.Operative and postoperative parameters such as duration of operation, bypass time, duration of ventilation, morbidity, and mortality were statistically analyzed using the Kruskal-Wallis test. Hemodynamic assessment with transthoracic echocardiography was performed before discharge.ResultsThe EuroSCORE II ranged between 0.67 and 6.94 with no significant difference between the groups. The median operative time was 166 min (range 90–230 min) in total, with significantly shorter times in group C (120 min [range 90–200]). The median total ventilation time was significantly lower in group C and significantly higher in group A. Hemodynamic evaluation demonstrated a mean maximal velocity (vmax) over the aortic valve of 2.3 m/s (range 0.9–4.3 m/s) with average mean and peak pressure gradient values of 10 mmHg (range 3–24 mmHg) and 20 mmHg (range 5–42 mmHg), respectively. Group A showed the highest values for vmax (H>5.99).No significant difference was found regarding duration of hospitalization. Mortality was 3%.ConclusionsIn conclusion, all 3 valves showed good perioperative results, satisfying hemodynamic performance, and low complication rates.

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Minimal access rapid deployment aortic valve replacement: Initial single-center experience and 12-month outcomes

Cited by 37 publications

References 29 publications

Direct Comparison of the Edwards Intuity Elite and Sorin Perceval S Rapid Deployment Aortic Valves

Direct Comparison of the Edwards Intuity Elite and Sorin Perceval S Rapid Deployment Aortic Valves

Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy

Initial Experience with Aortic Valve Replacement via a Minimally Invasive Approach: A Comparison of Stented, Stentless and Sutureless Valves

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