Marco Di Eusanio1,2, Kevin Phan2, Paolo Berretta1, Thierry P Carrel3, Martin Andreas4, Giuseppe Santarpino5,6, Roberto Di Bartolomeo7, Thierry Folliguet8, Bart Meuris9, Carmelo Mignosa10, Gianluca Martinelli11, Martin Misfeld12, Mattia Glauber13, Utz Kappert14, Malak Shrestha15, Alberto Albertini16, Kevin Teoh17, Emmanuel Villa18, Tristan Yan2,19, Marco Solinas20. 1. Cardiovascular Department, Cardiac Surgery Unit, Ospedali Riuniti, Polytechnic University of Marche, Ancona, Italy. 2. The Collaborative Research (CORE) Group, Sydney, Australia. 3. Hopital Universitaire de Berne, Berne, Switzerland. 4. Medical University of Vienna, Vienna, Austria. 5. Città di Lecce Hospital, GVM Care & Research, Lecce, Italy. 6. Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany. 7. Department of Cardiac Surgery, Sant'Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 8. Centre Hospitalier Universitaire de Nancy, Université de Lorraine, Nancy, France. 9. Gasthuisberg, Cardiale Heelkunde, Leuven, Belgium. 10. Cardiac Surgery Unit, Centro Clinico-Diagnostico 'G.B. Morgagni', Heart Center, Pedara, Italy. 11. Cardiovascular Department, Clinica San Gaudenzio, Novara, Italy. 12. University of Leipzig, Leipzig, Germany. 13. Istituto Clinico Sant'Ambrogio, Clinical & Research Hospitals IRCCS Gruppo San Donato, Milan, Italy. 14. Dresden Heart Center, Department of Cardiac Surgery, Dresden University Hospital, Dresden, Germany. 15. Hannover Medical School, Hannover, Germany. 16. Salus Hospital, GVM Care & Research, Reggio Emilia, Italy. 17. Southlake Regional Health Centre, Newmarket, ON, Canada. 18. Poliambulanza Foundation Hospital, Brescia, Italy. 19. Macquarie University, Sydney, Australia. 20. Pasquinucci Heart Hospital, Massa, Italy.
Abstract
OBJECTIVES: The Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR) was established by a consortium of 18 research centres-the International Valvular Surgery Study Group (IVSSG)-to overcome limitations of the literature and provide adequately powered evidence on sutureless and rapid-deployment aortic valves replacement (SURD-AVR). METHODS: Data from 3343 patients undergoing SURD-AVR over a 10-year period (2007-2017) were collected in the registry. The mean age of the patients was 76.8 ± 6.7 years, with 36.4% being 80 years or older. The average logistic EuroSCORE was 11.3 ± 9.7%. RESULTS: Isolated SURD-AVR was performed in 70.7% (n = 2362) of patients using full sternotomy (35.3%) or less invasive approaches (64.8%). Overall hospital mortality was 2.1%, being 1.4% in patients who had isolated SURD-AVR and 3.5% in those who had concomitant procedures (P < 0.001). When considering baseline risk profile, mortality rate was 0.8% and 1.9% in low risk (logistic EuroSCORE <10%) isolated SURD-AVR and combined SURD-AVR, respectively, and 2.2% and 3.7% in higher risk patients (logistic EuroSCORE ≥10%). Postoperative neurological complications included stroke (2.8%) and transient ischaemic attack (1.1%). New atrioventricular block requiring pacemaker occurred in 10.4% of the patients. The rate of pacemaker implantation significantly decreased over time [from 17.2% (2007-2008) to 5.4% (2016); P = 0.02]. CONCLUSIONS: Our findings showed that SURD-AVR is a safe and effective alternative to conventional aortic valve replacement and is associated with excellent clinical outcomes. Further adequately powered statistical analyses from the retrospective and prospective SURD-IR will allow for the development of high-quality evidence-based clinical guidelines for SURD-AVR.
OBJECTIVES: The Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR) was established by a consortium of 18 research centres-the International Valvular Surgery Study Group (IVSSG)-to overcome limitations of the literature and provide adequately powered evidence on sutureless and rapid-deployment aortic valves replacement (SURD-AVR). METHODS: Data from 3343 patients undergoing SURD-AVR over a 10-year period (2007-2017) were collected in the registry. The mean age of the patients was 76.8 ± 6.7 years, with 36.4% being 80 years or older. The average logistic EuroSCORE was 11.3 ± 9.7%. RESULTS: Isolated SURD-AVR was performed in 70.7% (n = 2362) of patients using full sternotomy (35.3%) or less invasive approaches (64.8%). Overall hospital mortality was 2.1%, being 1.4% in patients who had isolated SURD-AVR and 3.5% in those who had concomitant procedures (P < 0.001). When considering baseline risk profile, mortality rate was 0.8% and 1.9% in low risk (logistic EuroSCORE <10%) isolated SURD-AVR and combined SURD-AVR, respectively, and 2.2% and 3.7% in higher risk patients (logistic EuroSCORE ≥10%). Postoperative neurological complications included stroke (2.8%) and transient ischaemic attack (1.1%). New atrioventricular block requiring pacemaker occurred in 10.4% of the patients. The rate of pacemaker implantation significantly decreased over time [from 17.2% (2007-2008) to 5.4% (2016); P = 0.02]. CONCLUSIONS: Our findings showed that SURD-AVR is a safe and effective alternative to conventional aortic valve replacement and is associated with excellent clinical outcomes. Further adequately powered statistical analyses from the retrospective and prospective SURD-IR will allow for the development of high-quality evidence-based clinical guidelines for SURD-AVR.
Authors: Michael L Williams; Campbell D Flynn; Andrew A Mamo; David H Tian; Utz Kappert; Manuel Wilbring; Thierry Folliguet; Antonio Fiore; Antonio Miceli; Augusto D'Onofrio; Giorgia Cibin; Gino Gerosa; Mattia Glauber; Theodor Fischlein; Francesco Pollari Journal: Ann Cardiothorac Surg Date: 2020-07
Authors: Antonio Miceli; Paolo Berretta; Antonio Fiore; Martin Andreas; Marco Solinas; Giuseppe Santarpino; Utz Kappert; Martin Misfeld; Carlo Savini; Alberto Albertini; Emmanuel Villa; Kevin Phan; Theodor Fischlein; Bart Meuris; Gianluca Martinelli; Kevin Teoh; Carmelo Mignosa; Malakh Shrestha; Thierry P Carrel; Tristan D Yan; Mattia Glauber; Marco Di Eusanio Journal: Ann Cardiothorac Surg Date: 2020-07
Authors: Iuliana Coti; Thomas Haberl; Sabine Scherzer; Paul Werner; Shiva Shabanian; Alfred Kocher; Guenther Laufer; Martin Andreas Journal: Ann Cardiothorac Surg Date: 2020-07
Authors: Paolo Berretta; Luca Montecchiani; Fabio Vagnarelli; Mariano Cefarelli; Jacopo Alfonsi; Carlo Zingaro; Filippo Capestro; Michele D Pierri; Alessandro D'alfonso; Marco Di Eusanio Journal: Ann Cardiothorac Surg Date: 2020-09
Authors: Isaac Wamala; Mossab Y Saeed; Peter E Hammer; Daniel Bautista-Salinas; Kimberlee Gauvreau; Sunil J Ghelani; Nikolay V Vasilyev; Pedro J Del Nido Journal: Interact Cardiovasc Thorac Surg Date: 2021-08-12
Authors: Martin Andreas; Paolo Berretta; Marco Solinas; Giuseppe Santarpino; Utz Kappert; Antonio Fiore; Mattia Glauber; Martin Misfeld; Carlo Savini; Elisa Mikus; Emmanuel Villa; Kevin Phan; Theodor Fischlein; Bart Meuris; Gianluca Martinelli; Kevin Teoh; Carmelo Mignosa; Malakh Shrestha; Thierry P Carrel; Tristan Yan; Guenther Laufer; Marco Di Eusanio Journal: Eur J Cardiothorac Surg Date: 2020-11-01 Impact factor: 4.191