Rapid deployment aortic valve replacement in a minimal access setting: intermediate clinical and echocardiographic outcomes†

Schlömicher, Markus; Taghiyev, Z.; Aljabery, Yazan; Haldenwang, Peter Lukas; Zumholz, Michael; Sikole, Magdalena; Useini, Dritan; Naraghi, Hamid; Moustafine, Vadim; Bechtel, Matthias; Strauch, Justus

doi:10.1093/ejcts/ezy023

Cited by 5 publications

(9 citation statements)

References 27 publications

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“…The death was due to non‐valve related cardiac failure. We have confirmed the excellent haemodynamic profile of RD valves (mean PG of 10 mm Hg [IQR: 9‐12]) which is reported previously 4,5,14,15 . There were no PVL or prosthesis failure in our study compared to a range between 0.6% and 2.5% in previous reports 15‐17 .…”

Section: Discussionsupporting

confidence: 90%

“…We have confirmed the excellent haemodynamic profile of RD valves (mean PG of 10 mm Hg [IQR: 9-12]) which is reported previously. 4,5,14,15 There were no PVL or prosthesis failure in our study compared to a range between 0.6% and 2.5% in previous reports. [15][16][17] The elimination of valve-related afterload led to a significant reduction in LV mass.…”

Section: Discussioncontrasting

confidence: 55%

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Rapid deployment aortic valve replacement through anterior right thoracotomy: Clinical outcomes and haemodynamic performance

et al. 2020

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Background The ease of implantation of the rapid deployment (RD) and sutureless valves has contributed to the adoption of anterior right thoracotomy (ART) approach for aortic valve replacement (AVR). Aim of the study This study evaluates the safety and haemodynamic performance of minimally invasive AVR through ART using the RD valves. Methods This is a retrospective, single‐center review of a total of 50 consecutive patients who received RD‐AVR through ART. Results The median age of patients was 75 years (interquartile range [IQR]: 69‐80), and median Euroscore II was 5.1 (IQR: 2.4‐7.5). ART RD‐AVR was successfully performed in all cases with no conversion to sternotomy, paravalvular leaks or need for valve explantation. The mean size of the implanted valve was 23.2 ± 2.3 mm. In‐hospital mortality was 2%. The mean and maximum pressure gradients across the aortic prosthesis were 10 mm Hg (IQR: 9‐12) and 19 mm Hg (IQR: 16‐23). Conclusions Rapid deployment aortic valve replacement can be safely performed through anterior right thoracotomy wit excellent haemodynamic performance and low postoperative complications rate.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 55%

Rapid deployment aortic valve replacement through anterior right thoracotomy: Clinical outcomes and haemodynamic performance

et al. 2020

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“…[1][2][3]9 The potential to accelerate AVR has been demonstrated in several publications. [1][2][3]9 Patients undergoing multiple valve surgery might potentially benefit from procedural optimization, considering the increased mortality in this setting. Al-Sarraf et al could demonstrate the close relationship between cross-clamp times, cardiopulmonary bypass times, and excess mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Short implantation times together with high success rates for rapid deployment valves have recently been demonstrated for along with superior hemodynamic properties. [1][2][3] Especially minimal access surgery can be simplified and accelerated through the systematic use of this technology. [1][2][3] Multiple valve surgery is associated with significant higher operative risks.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Especially minimal access surgery can be simplified and accelerated through the systematic use of this technology. [1][2][3] Multiple valve surgery is associated with significant higher operative risks. Reduced cross-clamp and cardiopulmonary bypass times in multiple valve surgery may potentially be beneficial as they can be considered independent risk factors for increased morbidity and mortality following cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

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Intermediate Outcomes after Rapid Deployment Aortic Valve Replacement in Multiple Valve Surgery

Schlömicher

Bechtel

Taghiyev

et al. 2019

Thorac Cardiovasc Surg

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Background Multiple valve surgery is associated with significant higher operative risks. Reduced cross-clamp and cardiopulmonary bypass times in multiple valve surgery may potentially be beneficial as they can be considered independent risk factors for increased morbidity and mortality following cardiac surgery. We report first intermediate outcomes of the Edwards Intuity valve system (Edwards Lifesciences, Irvine, California, United States) in combined procedures Methods Fifty-eight patients underwent rapid deployment aortic valve replacement with concomitant mitral valve surgery between January 2014 and November 2017 in our institution. The valve was assessed echocardiographically after 12 months. The median follow-up was 1.7 years with a cumulative follow-up time of 115.3 patient years. Results The mean age was 73.5 ± 6.2 years and the mean logistic Euroscore was 11.6 ± 3.1%. Concomitant mitral valve repair was performed in 43 cases (74.1%), and mitral valve replacement in 15 cases (19.0%). The mean cross-clamp time was 93 ± 21 minutes along with a mean bypass time of 118 ± 24 minutes. All-cause mortality after 30 days was 8.6%. Overall actuarial survival at 1 year was 87.2 ± 4.5% and after 2 years 82.8 ± 5.3%, respectively. Conclusions Rapid deployment aortic valve replacement in multiple valve surgery can be performed safely with good intermediate outcomes in elderly, high-risk patients.

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Single-Center Outcomes with Rapid Deployment Aortic Valve Replacement

Schlömicher

Bechtel

Useini

et al. 2020

Thorac Cardiovasc Surg

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Objectives Rapid-deployment valves can reduce procedural times and may facilitate minimally invasive surgery. In our institution, more than 500 patients underwent rapid deployment aortic valve replacement (AVR). Methods A total of 510 patients underwent rapid deployment AVR between March 2012 and September 2017, of whom 270 patients underwent isolated AVR and 240 underwent AVR with concomitant procedures. The cumulative follow-up time was 1,444 patient-years, the median follow-up time 2.8 years, respectively Results An early all-cause mortality of 3.5% (n = 18) was seen with a cumulative survival of 91.9 ± 2.2% after 12 months. Mean cross-clamp times were 37 ± 19 minutes for isolated AVR and 93 ± 29 minutes for AVR with concomitant procedures. The rate of new pacemaker implantation was 7.8% (n = 40). No case of structural degeneration occurred in the follow-up. Three (0.6%) cases of endocarditis were registered. Conclusions Rapid deployment AVR can be performed safely with low complication rates and good hemodynamic results. Therefore, the relevance in aortic valve surgery can be stressed.

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Rapid deployment aortic valve replacement in a minimal access setting: intermediate clinical and echocardiographic outcomes†

Abstract: Rapid deployment aortic valve replacement can be performed safely in a minimal access setting with low complication rates and good haemodynamic results. Therefore, rapid deployment valves are a relevant option in minimal access surgery.

Cited by 5 publications

References 27 publications

Rapid deployment aortic valve replacement through anterior right thoracotomy: Clinical outcomes and haemodynamic performance

Rapid deployment aortic valve replacement through anterior right thoracotomy: Clinical outcomes and haemodynamic performance

Intermediate Outcomes after Rapid Deployment Aortic Valve Replacement in Multiple Valve Surgery

Single-Center Outcomes with Rapid Deployment Aortic Valve Replacement

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