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. 2019 Jul 1;56(1):38-43.
doi: 10.1093/ejcts/ezy477.

Operative outcome of patients at low, intermediate, high and 'very high' surgical risk undergoing isolated aortic valve replacement with sutureless and rapid deployment prostheses: results of the SURD-IR registry

Giuseppe Santarpino  1   2 , Paolo Berretta  3 , Theodor Fischlein  2 , Thierry P Carrel  4 , Kevin Teoh  5 , Martin Misfeld  6 , Carlo Savini  7 , Utz Kappert  8 , Mattia Glauber  9 , Emmanuel Villa  10 , Bart Meuris  11 , Carmelo Mignosa  12 , Alberto Albertini  13 , Gianluca Martinelli  14 , Thierry A Folliguet  15 , Malak Shrestha  16 , Marco Solinas  17 , Günther Laufer  18 , Kevin Phan  19 , Tristan Yan  19   20 , Marco Di Eusanio  19   21
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Free article

Operative outcome of patients at low, intermediate, high and 'very high' surgical risk undergoing isolated aortic valve replacement with sutureless and rapid deployment prostheses: results of the SURD-IR registry

Giuseppe Santarpino et al. Eur J Cardiothorac Surg. .
Free article

Abstract

Objectives: The ideal strategy for the treatment of severe aortic valve stenosis in patients of varying risk categories has become a debated topic in the last years: should the transcatheter or surgical approach be adopted? The aim of this study was to evaluate the outcomes of low-, intermediate-, high- and very high-risk patients undergoing sutureless, rapid deployment aortic valve replacement.

Methods: From 2007 to 2017, data on a total of 3651 patients were collected from the Sutureless and Rapid Deployment Aortic Valve Replacement International Registry (SURD-IR). Of these, 2057 patients who underwent primary isolated aortic valve replacement were considered for this analysis and classified as being at low (EuroSCORE <5; n = 500), intermediate (EuroSCORE 5-10; n = 901), high (EuroSCORE 11-20; n = 500) and very high (EuroSCORE >20; n = 156) preoperative risk.

Results: Overall, a less invasive approach was used in 74.1% of patients and represented the most frequent (>50%) approach in all risk categories. The Perceval prosthesis was used more frequently than other devices, especially in patients at high and very high risk. Hospital mortality was 1.6%, 0.8%, 1.9% and 2.7% in low-, intermediate-, high- and very high-risk patients, respectively, with no significant differences among subgroups. Similarly, postoperative complication rates were similar across the different risk categories.

Conclusions: Surgical aortic valve replacement using sutureless, rapid deployment biological valve prostheses is associated with excellent results and represents a safe and effective treatment option for patients with severe aortic valve stenosis. This seems to be particularly true in patients with a higher risk profile.

Keywords: Aortic valve replacement; Aortic valve stenosis; Rapid deployment aortic valve; Sutureless aortic valve.

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