Outcome of rapid deployment aortic valves: long-term experience after 700 implants

Coti, Iuliana; Haberl, T.; Scherzer, Sabine; Werner, Paul; Shabanian, Shiva; Kocher, Alfred; Laufer, Guenther; Andreas, Martin

doi:10.21037/acs.2020.04.01

Cited by 22 publications

(29 citation statements)

References 22 publications

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“…SBs have demonstrated in large series and multicenter studies that they provide satisfactory results with low operative mortality, constantly improving outcomes, even when associated procedures are performed, and promising medium-term data [ 30 , 31 , 32 ]. Similar results have been reported with RDBs with regard to safety, hemodynamic performance, and favorable outcomes [ 33 , 34 , 35 , 36 ]. Based on the currently available data, both SBs and RDBs are considered valid alternatives to conventional prostheses for AVR.…”

Section: Discussionsupporting

confidence: 84%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

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Sutureless and rapid-deployment bioprostheses have been introduced as alternatives to traditional prosthetic valves to reduce cardiopulmonary and aortic cross-clamp times during aortic valve replacement. These devices have also been employed in extremely demanding surgical settings, as underlined in the present review. Searches on the PubMed and Medline databases aimed to identify, from the English-language literature, the reported cases where both sutureless and rapid-deployment prostheses were employed in challenging surgical situations, usually complex reoperations sometimes even performed as bailout procedures. We have identified 25 patients for whom a sutureless or rapid-deployment prosthesis was used in complex redo procedures: 17 patients with a failing stentless bioprosthesis, 6 patients with a failing homograft, and 2 patients with the failure of a valve-sparing procedure. All patients survived reoperation and were reported to be alive 3 months to 4 years postoperatively. Sutureless and rapid-deployment bioprostheses have proved effective in replacing degenerated stentless bioprostheses and homografts in challenging redo procedures. In these settings, they should be considered as a valid alternative not only to traditional prostheses but also in selected cases to transcatheter valve-in-valve solutions.

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Section: Discussionsupporting

confidence: 84%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

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“…In our study, overall mortality was 12.4% and overall survival probability 85.9% (95% CI, 80.8–91.3) at 5 years. Other trials report similar patient survival, ranging from 76.0% to 86.0% 7–9 . Findings from the OBSERVANT registry 13 of 1300 matched patients undergoing TAVR and SAVR showed that at five years, estimates of death from any cause were 35.8% in the SAVR group and 44.5% in the TAVR group.…”

Section: Commentmentioning

confidence: 90%

Five‐year outcomes of rapid‐deployment aortic valve replacement with the Edwards Intuity valve

Pelcé

Porto

Gariboldi

et al. 2021

Journal of Cardiac Surgery

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Background This report presents 5‐year outcomes of the rapid‐deployment Edwards Intuity valve in a prospective, single‐center study. Methods All patients who underwent an aortic valve replacement (AVR) with an Edwards Intuity bioprosthesis at La Timone Hospital, Marseille, France, from July 2012 to June 2015 were assessed over a 5‐year follow‐up period. The primary outcome was overall mortality at 5 years. Secondary outcomes were reoperation, overall mortality and stroke, cardiovascular mortality, composite endpoints defined by the updated Valve Academic Research Consortium‐2 (VARC‐2), periprosthetic regurgitation, prosthesis‐patient mismatch, and the need for new pacemaker implantation. Results In total, 170 consecutive patients were assessed, of which 67.1% were males. The mean age was 76 years, mean EuroSCORE II was 3.5% and 5‐year overall mortality was 12.4%. At 5 years, reoperation was 2.9%, overall mortality and stroke was 4.1% per patient‐year, and cardiovascular mortality was 4.7%. VARC clinical efficacy and VARC time‐related valve safety were achieved in 46.0% and 59.9% of patients, respectively. At one month VARC device success was 71.2% and VARC early safety was 87.1%. At one year, mild and moderate periprosthetic regurgitation were 2.4% and 0.6%, respectively, and moderate and severe prosthesis‐patient mismatch were 18.8% and 4.8%, respectively. Conduction disturbances needing new PPI occurred in 3.5% patients. Conclusion The 5‐year outcomes of AVR with the Edwards Intuity valve system demonstrate satisfactory midterm safety and excellent haemodynamic performance.

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“…In high-risk patients with prior coronary artery bypass grafting (CABG), the noninferiority or superiority of TAVR compared with SAVR has been reported in a subgroup analysis of randomized trials, retrospective single-center studies, and meta-analyses [Coti 2020;Ando 2016;Kocher 2013;Baumgartner 2017].…”

Section: Introductionmentioning

confidence: 99%

Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting

Yamamoto

Endo

Yamaoka

et al. 2021

HSF

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Background: Aortic valve reoperation increases the risk of mortality and morbidity. The 2017 European Society of Cardiology guidelines for managing valvular heart disease with a previous heart surgery and intact bypass grafts consider patients with high surgical risk to be injury-prone during sternotomy. In high-risk patients with prior coronary artery bypass grafting, several authors have reported the noninferiority or superiority of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement; however, in Japan, TAVR cannot be performed for patients on hemodialysis. In this study, we report a case of successful implantation of the new rapid-deployment bioprosthesis in a 65-year-old Japanese man on dialysis with prior coronary artery bypass grafting. Methods: The rapid-deployment aortic valve system has demonstrated excellent hemodynamic performance, durability, and safety. However, implantation requires speciﬁc training and the analysis of preoperative 3D computed tomographic imaging. The cineangiography revealed patency of all grafts, and the saphenous vein graft (SVG) had overlapped the planned aortotomy position. By avoiding the anastomotic part of the SVG, we could perform rapid-deployment aortic valve replacement efficiently even if the aortic incision was repositioned, and the incision was smaller than planned. Results: We used the 23-mm Intuity valve without an additional stitch, and the cardiopulmonary bypass and aortic cross-clamp times were only 52 and 39 minutes, respectively. Conclusion: This novel valve may be beneﬁcial in complex combinational procedures for hemodialysis patients with prior coronary artery bypass grafting.

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Outcome of rapid deployment aortic valves: long-term experience after 700 implants

Cited by 22 publications

References 22 publications

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Five‐year outcomes of rapid‐deployment aortic valve replacement with the Edwards Intuity valve

Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting

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