Oliver J Liakopoulos1, Stephen Gerfer2, Simone Weider2, Parwis Rahmanian2, Mohamed Zeriouh2, Kaveh Eghbalzadeh2, Anton Sabashnikov2, Yeong-Hoon Choi2, Jens Wippermann3, Thorsten Wahlers2. 1. Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany. Electronic address: oliver.liakopoulos@uk-koeln.de. 2. Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany. 3. Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany; Department of Cardiothoracic Surgery at the University Hospital Magdeburg, Magdeburg, Germany.
Abstract
BACKGROUND: Rapid deployment aortic valve replacement (RDAVR) has emerged as an attractive alternative to conventional aortic valve replacement. This single-center study directly compared two commercially available rapid deployment valves with regard to clinical outcomes, valve-related complications, and hemodynamic performance. METHODS: A total of consecutive 156 patients underwent RDAVR with the Intuity Elite (Edwards Lifesciences, Irvine, CA [Intuity group, n = 117] or the Perceval S (Sorin Group Italia Srl, Saluggia, Italy [Perceval group, n = 39]) between September 2012 and March 2016 at our institution. Perioperative data, including 30-day all-cause mortality, and echocardiographic measurements were assessed and retrospectively analyzed from our institutional database. RESULTS: Preoperative variables, including mean age (77 ± 5 years), European System for Cardiac Operative Risk Evaluation (6.8 ± 2.1), and body mass index (27 ± 5 kg/m2), did not differ between groups. More male patients (60% versus 15%) with a higher body surface area (1.9 ± 0.2 m2 versus 1.7 ± 0.2 m2) and body weight (78 ± 13 kg versus 71 ± 15 kg) were in the Intuity group compared with the Perceval group, respectively (p < 0.05). Implanted RDAVR size (23.3 ± 1.8 mm versus 23.4 ± 1.5 mm), concomitant coronary artery bypass graft surgery (48% versus 33%), number of grafts, cardiopulmonary bypass, and aortic clamp time were comparable between the Intuity group and the Perceval group. Thirty-day mortality (Intuity 2.6% versus Perceval 5.1%) and valve-related complications (Intuity 12.0% versus Perceval 20.5%), including postoperative pacemaker implantation (Intuity 8.5% versus Perceval 12.8%), did not differ between groups. At discharge echocardiography, indexed effective orifice area was higher in the Intuity group, but peak or mean pressure gradients were comparable between groups. CONCLUSIONS: Performing RDAVR with the Intuity and Perceval rapid deployment valves provides comparable good clinical outcomes and valve hemodynamics, with low valve-related complication rates. The rate of pacemaker implantation was comparable for both rapid deployment valves, ranging from 8% to 13%.
BACKGROUND: Rapid deployment aortic valve replacement (RDAVR) has emerged as an attractive alternative to conventional aortic valve replacement. This single-center study directly compared two commercially available rapid deployment valves with regard to clinical outcomes, valve-related complications, and hemodynamic performance. METHODS: A total of consecutive 156 patients underwent RDAVR with the Intuity Elite (Edwards Lifesciences, Irvine, CA [Intuity group, n = 117] or the Perceval S (Sorin Group Italia Srl, Saluggia, Italy [Perceval group, n = 39]) between September 2012 and March 2016 at our institution. Perioperative data, including 30-day all-cause mortality, and echocardiographic measurements were assessed and retrospectively analyzed from our institutional database. RESULTS: Preoperative variables, including mean age (77 ± 5 years), European System for Cardiac Operative Risk Evaluation (6.8 ± 2.1), and body mass index (27 ± 5 kg/m2), did not differ between groups. More male patients (60% versus 15%) with a higher body surface area (1.9 ± 0.2 m2 versus 1.7 ± 0.2 m2) and body weight (78 ± 13 kg versus 71 ± 15 kg) were in the Intuity group compared with the Perceval group, respectively (p < 0.05). Implanted RDAVR size (23.3 ± 1.8 mm versus 23.4 ± 1.5 mm), concomitant coronary artery bypass graft surgery (48% versus 33%), number of grafts, cardiopulmonary bypass, and aortic clamp time were comparable between the Intuity group and the Perceval group. Thirty-day mortality (Intuity 2.6% versus Perceval 5.1%) and valve-related complications (Intuity 12.0% versus Perceval 20.5%), including postoperative pacemaker implantation (Intuity 8.5% versus Perceval 12.8%), did not differ between groups. At discharge echocardiography, indexed effective orifice area was higher in the Intuity group, but peak or mean pressure gradients were comparable between groups. CONCLUSIONS: Performing RDAVR with the Intuity and Perceval rapid deployment valves provides comparable good clinical outcomes and valve hemodynamics, with low valve-related complication rates. The rate of pacemaker implantation was comparable for both rapid deployment valves, ranging from 8% to 13%.
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