Abstract 19955: Rapid Deployment Aortic Valve Shows Satisfactory Immediate Outcomes in High-risk Patients, as a Valid Alternative in the Era of Transcatheter Aortic Valve Implantation
Introduction: In the last few years, alongside the development of Transcatheter Aortic Valve Implantation, new surgical aortic valve have entered the clinical arena as alternative treatment in high-risk patient.
Hypothesis: To assess the immediate outcomes in high-risk patients undergone Rapid Deployment Aortic Valve Replacement (RD-AVR).
Methods: From April 2014 to June 2016, 83 patients (mean age 79.15 ± 5.99 years, mean logistic Euroscore 10.58 ± 5.62) underwent RD-AVR. Octogenarians constituted 53.01% of the cohort (n=44). Conventional median sternotomy (n=71, 85.54%) or minimally invasive technique (n=12, 14.45%) were choose according the different cases.
Results: An Intuity Elite Valve System was successfully implanted in all patients, except one (success rate, 96.32%). In-hospital mortality was 1.2%. The mean aortic cross clamping time was 53.36 ± 22.07 minutes, significantly lower for isolated RD-AVR, 38.96 ± 8.63 minutes, than for RD-AVR plus other concomitant procedures, 64.91 ± 11.96 minutes, p<0.001. Mean hospital stay was 11.35 ± 6.38 days; this was shorter in those patients underwent minimally invasive approach (7.67 ± 2.12 vs 11.45 ± 6.45). Freedom from permanent pacemaker implantation and stroke was 96.38%, and 98.79%, respectively. No para-valvular leakage, more than mild, was observed. Mean post-operative effective orifice area index (EOAi) was 0.77 cm2/m2; a severe patient-prosthesis mismatch was observed in 1 patient (1.2%), who was asymptomatic.
Conclusions: Aortic valve replacement with Intuity Elite Valve System appears to be an easily reproducible technique with satisfactory immediate outcomes in high-risk patients. Minimally invasive approach provides a faster recovery. More investigations are needed to assess the long-term outcomes of these new aortic valves.
Author Disclosures: V. Caruso: None. D. Titmarsh: None. K. Hassan: None. S. Bhusari: None. I. Birdi: None.
- © 2016 by American Heart Association, Inc.