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Rapid-deployment aortic valve replacement for severe aortic stenosis: 1-year outcomes in 150 patients.
- Source :
-
Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2017 Jul 01; Vol. 25 (1), pp. 68-74. - Publication Year :
- 2017
-
Abstract
- Objectives: This study aimed to evaluate the safety and effectiveness of rapid-deployment aortic valve replacement (RDAVR) for severe aortic stenosis (AS).<br />Methods: All consecutive patients with severe AS who underwent RDAVR with the EDWARDS INTUITY bioprosthesis were prospectively included in a single-centre, cohort study between July 2012 and April 2015. Clinical examination and transthoracic echocardiography were performed preoperatively and at 1-month and 1-year follow-up.<br />Results: We included 150 patients: mean age 76.8 ± 6.2 years, 68.7% male and mean EuroSCORE II 3.4 ± 3.7%. Implantation was successful in all: 103 (68.7%) had isolated aortic valve replacement (AVR) and 47 (31.3%) had concomitant procedures. For isolated AVR, mean cross-clamp and cardiopulmonary bypass times were 37.6 ± 13.3 and 59.9 ± 20.4 min, respectively. Overall, the 1-year Kaplan-Meier survival rate was 97.1% (95% confidence interval 92.4-98.9%). At 1 year, stroke occurred in 5 patients (3.34%), myocardial infarction in 1 (0.69%), endocarditis in 1 (0.69%), early explantation in 1 (0.67%), pacemaker implantation in 8 (5.6%) and Grade 2 periprosthetic regurgitation in 4 (3.2%; no grade 3 of 4). There were significant decreases from baseline ( P < 0.001) in the proportion at New York Heart Association Class III/V (35.3-4.1%), mean gradient (54.9 ± 17.3 mmHg to 11.3 ± 4.8 mmHg) and mean left ventricular mass index (160.3 ± 44.8 g/m 2 to 118.5 ± 39.4 g/m 2 ). Mean indexed effective orifice area at 1 year was 1.02 ± 0.37 cm 2 /m 2 . Ten patients (6.6%) had severe patient-prosthesis mismatch.<br />Conclusions: RDAVR for severe AS provided favourable outcomes over 1 year.<br /> (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Subjects :
- Aged
Aortic Valve Stenosis diagnosis
Aortic Valve Stenosis mortality
Echocardiography
Female
Follow-Up Studies
France epidemiology
Humans
Male
Pericardium transplantation
Prospective Studies
Prosthesis Design
Severity of Illness Index
Survival Rate trends
Time Factors
Aortic Valve surgery
Aortic Valve Stenosis surgery
Bioprosthesis
Heart Valve Prosthesis Implantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1569-9285
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Interactive cardiovascular and thoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 28369288
- Full Text :
- https://doi.org/10.1093/icvts/ivx050