Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021;13(1):23-27.
doi: 10.34172/jcvtr.2021.10. Epub 2021 Jan 30.

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Adama Sawadogo  1   2 , An Vinh Bui-Duc  1   3 , Nicolas D'Ostrevy  1 , Lionel Camilleri  1 , Kasra Azarnoush  1
Affiliations

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Adama Sawadogo et al. J Cardiovasc Thorac Res. 2021.

Abstract

Introduction: Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. In high-risk patients, conventional aortic valve replacement (C-AVR) carries high rates of morbidity and mortality. In the last few years, rapid-deployment valves (RDV) have been developed to reduce the surgical risks. In this work, we aimed to compare the mid-term outcomes of rapid-deployment AVR (RD-AVR) with those of the C-AVR in high-risk patients. Methods: This retrospective case-control study identified 23 high-risk patients who underwent RD-AVR between 12/2015 to 01/2018. The study group was compared with a control group of 46 patients who were retrospectively selected from a database of 687 C-AVR patients from 2016 to 2017 which matched with the study group for age and Euro SCORE II. Results: RD-AVR group presented more cardiovascular risk factors. Euro SCORE II was higher in the RD-AVR group (P =0.06). In the RD-AVR group, we observed significantly higher mean prosthetic size (P <0.001). In-hospital mortality was zero in RD-AVR group versus 2 deaths in C-AVR group. Hospital stay was longer in the RD-AVR group with statistical significance (P =0.03). In the group AVR with associated cardiac procedures, while comparing subgroups RD-AVR versus C-AVR, early mean gradient was lower in the first cited (P =0.02). The overall mean follow-up was 10.9 ± 4.3 months. Conclusion: The RD-AVR technique is reliable and lead to positive outcomes. This procedure provides a much larger size with certainly better flow through the aortic root. It is an alternative to C-AVR in patients recognized to be surgically fragile.

Keywords: Aortic Valve Replacement; Calcified Aortic Stenosis; EuroSCORE II; Rapid Deployment Aortic Valve.

PubMed Disclaimer

References

    1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA. et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440–2492. doi: 10.1161/cir.0000000000000029. - DOI - PubMed
    1. Frilling B, von Renteln-Kruse W, Riess FC. Evaluation of operative risk in elderly patients undergoing aortic valve replacement: the predictive value of operative risk scores. Cardiology. 2010;116(3):213–218. doi: 10.1159/000319703. - DOI - PubMed
    1. Rubino AS, Biancari F, Caruso V, Lavanco V, Privitera F, Rinaldi I. et al. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography. Echocardiography. 2018;35(1):64–70. doi: 10.1111/echo.13735. - DOI - PubMed
    1. Hanedan MO, Yuruk MA, Parlar AI, Ziyrek U, Arslan AK, Sayar U. et al. Sutureless versus conventional aortic valve replacement: outcomes in 70 high-risk patients undergoing concomitant cardiac procedures. Tex Heart Inst J. 2018;45(1):11–16. doi: 10.14503/thij-16-6092. - DOI - PMC - PubMed
    1. Baran C, Durdu MS, Gumus F, Cakici M, Inan MB, Sirlak M. et al. Sutureless aortic valve replacement with concomitant valvular surgery. J Thorac Cardiovasc Surg. 2018;155(6):2414–2422. doi: 10.1016/j.jtcvs.2017.12.154. - DOI - PubMed

LinkOut - more resources