Paolo Berretta1, Sebastian Arzt2, Antonio Fiore3, Thierry P Carrel4, Martin Misfeld5, Kevin Teoh6, Emmanuel Villa7, Alberto Albertini8, Theodor Fischlein9, Gianluca Martinelli10, Malak Shrestha11, Carlo Savini12, Antonio Miceli13, Giuseppe Santarpino14, Martin Andreas15, Carmelo Mignosa16, Kevin Phan17, Bart Meuris18, Marco Solinas19, Tristan Yan17,20, Marco Di Eusanio1,17. 1. Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ospedali Riuniti, Ancona, Italy. 2. Department of Cardiac Surgery, University Heart Centre Dresden, Dresden, Germany. 3. Henri Mondor Hospital, University of Paris, Paris, France. 4. Department of Cardiovascular Surgery, University Hospital, University of Bern, Bern, Switzerland. 5. University Clinic for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany. 6. Southlake Regional Health Centre, Newmarket, ON, Canada. 7. Poliambulanza Foundation Hospital, Brescia, Italy. 8. Cardiovascular Surgery Unit, Maria Cecilia Hospital GVM Care & Research, Cotignola, Italy. 9. Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany. 10. Cardiovascular Department, Clinica San Gaudenzio, Novara, Italy. 11. Hannover Medical School, Hannover, Germany. 12. Cardiac Surgery Department, Sant'Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 13. Istituto Clinico Sant'Ambrogio, Clinical & Research Hospitals IRCCS Gruppo San Donato, Milan, Italy. 14. Città di Lecce Hospital, GVM Care & Research, Lecce, Italy. 15. Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. 16. Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy. 17. The Collaborative Research (CORE) Group, Sydney, Australia. 18. Gasthuisberg, Cardiale Heelkunde, Leuven, Belgium. 19. Pasquinucci Heart Hospital, Massa, Italy. 20. Department of Cardiothoracic Surgery, The Royal Prince Alfred Hospital, Sydney, Australia.
Abstract
OBJECTIVES: Current evidence on sutureless and rapid deployment aortic valve replacement (SURD-AVR) is limited and does not allow for the assessment of the clinical impact and the evolution of procedural and clinical outcomes of this new valve technology. The Sutureless and Rapid Deployment International Registry (SURD-IR) represents a unique opportunity to evaluate the current trends and outcomes of SURD-AVR interventions. METHODS: Data from 3682 patients enrolled between 2007 and 2018 were analysed. Patients were divided according to the date of surgery into 6 equal groups and by the type of intervention: isolated SURD-AVR (n = 2472) and combined SURD-AVR (n = 1086). RESULTS: Across the 11-year study period, significant changes occurred in patient characteristics including a decrease in age and in estimated surgical risk. Less invasive approaches for isolated SURD-AVR increased considerably from 49.4% to 85.5%. The overall in-hospital mortality rate was 1.6% and 3.9% in isolated and combined procedures, respectively, with no change over time. The rate of perioperative stroke decreased significantly (from 4% to 0.5%), as did the rates of postoperative pacemaker implantation (from 12.8% to 5.9%) and aortic regurgitation (from 17.8% to 2.7%). CONCLUSIONS: The present study provides a comprehensive analysis of the current trends and results of SURD-AVR interventions. The most notable changes over time were the increasing implantation of SURD valves in a younger population, with more frequent utilization of less invasive techniques. SURD-AVR demonstrated remarkable improvements in clinical outcomes with a significant reduction in the rates of stroke, pacemaker implantation and postoperative aortic regurgitation.
OBJECTIVES: Current evidence on sutureless and rapid deployment aortic valve replacement (SURD-AVR) is limited and does not allow for the assessment of the clinical impact and the evolution of procedural and clinical outcomes of this new valve technology. The Sutureless and Rapid Deployment International Registry (SURD-IR) represents a unique opportunity to evaluate the current trends and outcomes of SURD-AVR interventions. METHODS: Data from 3682 patients enrolled between 2007 and 2018 were analysed. Patients were divided according to the date of surgery into 6 equal groups and by the type of intervention: isolated SURD-AVR (n = 2472) and combined SURD-AVR (n = 1086). RESULTS: Across the 11-year study period, significant changes occurred in patient characteristics including a decrease in age and in estimated surgical risk. Less invasive approaches for isolated SURD-AVR increased considerably from 49.4% to 85.5%. The overall in-hospital mortality rate was 1.6% and 3.9% in isolated and combined procedures, respectively, with no change over time. The rate of perioperative stroke decreased significantly (from 4% to 0.5%), as did the rates of postoperative pacemaker implantation (from 12.8% to 5.9%) and aortic regurgitation (from 17.8% to 2.7%). CONCLUSIONS: The present study provides a comprehensive analysis of the current trends and results of SURD-AVR interventions. The most notable changes over time were the increasing implantation of SURD valves in a younger population, with more frequent utilization of less invasive techniques. SURD-AVR demonstrated remarkable improvements in clinical outcomes with a significant reduction in the rates of stroke, pacemaker implantation and postoperative aortic regurgitation.
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: Kei Woldendorp; Mathew P Doyle; Paul G Bannon; Martin Misfeld; Tristan D Yan; Giuseppe Santarpino; Paolo Berretta; Marco Di Eusanio; Bart Meuris; Alfredo Giuseppe Cerillo; Pierluigi Stefàno; Niccolò Marchionni; Jacqueline K Olive; Tom C Nguyen; Marco Solinas; Giacomo Bianchi Journal: Ann Cardiothorac Surg Date: 2020-09