Antonio Miceli1, Paolo Berretta2, Antonio Fiore3, Martin Andreas4, Marco Solinas5, Giuseppe Santarpino6,7,8, Utz Kappert9, Martin Misfeld10,11, Carlo Savini12, Alberto Albertini13, Emmanuel Villa14, Kevin Phan15, Theodor Fischlein8, Bart Meuris16, Gianluca Martinelli17, Kevin Teoh18, Carmelo Mignosa19, Malakh Shrestha20, Thierry P Carrel21, Tristan D Yan11,15, Mattia Glauber1, Marco Di Eusanio2,15. 1. Minimally Invasive Cardiac Surgery, Istituto Clinico Sant'Ambrogio, Milan, Italy. 2. Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ospedali Riuniti, Ancona, Italy. 3. Department of Cardiac Surgery, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France. 4. Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. 5. Department of Cardiac Surgery, Pasquinucci Heart Hospital, Massa, Italy. 6. Department of Cardiac Surgery, Città di Lecce Hospital, GVM Care & Research, Lecce, Italy. 7. Cardiac Surgery Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy. 8. Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany. 9. Department of Cardiac Surgery, University Heart Centre Dresden, Dresden, Germany. 10. University Clinic for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany. 11. Department of Cardiothoracic Surgery, The Royal Prince Alfred Hospital, Sydney, Australia. 12. Cardiac Surgery Department, Sant'Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 13. Cardiovascular Surgery Unit, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. 14. Department of Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy. 15. The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia. 16. Gasthuisberg, Cardiale Heelkunde, Leuven, Belgium. 17. Cardiovascular Department, Clinica San Gaudenzio, Novara, Italy. 18. Southlake Regional Health Centre, Ontario, Canada. 19. Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS-ISMETT, Palermo, Italy. 20. Division of Cardiothoracic Surgery, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. 21. Department of Cardiovascular Surgery, University Hospital, University of Bern, Bern, Switzerland.
Abstract
BACKGROUND: Benefits of sutureless and rapid deployment (SURD) bioprostheses in bicuspid aortic valves (BAV) are controversial. The aim of this study is to report the outcomes of patients undergoing aortic valve replacement (AVR) for BAV from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR). METHODS: Of the 4,636 patients who received primary isolated SURD-AVR between 2007 and 2018, 191 (4.1%) BAV patients underwent AVR with SURD valve. RESULTS: Overall 30-day mortality was 1.6%. The Intuity valve was implanted in 53.9% of cases, whereas the Perceval was implanted in 46.1%. Rate of stroke for isolated AVR was 4.2%. No case of endocarditis, thromboembolism, myocardial infarction, valve dislocation or structural valve deterioration was reported in the early phase. Rate of pacemaker implantation and moderate-severe aortic regurgitation (AR) were 7.9% and 3.7%, respectively. CONCLUSIONS: BAV is not considered a contraindication for the implantation of SURD valves. However, detailed information of aortic root geometry as well as the knowledge of some technical considerations are mandatory for a good outcome. 2020 Annals of Cardiothoracic Surgery. All rights reserved.
BACKGROUND: Benefits of sutureless and rapid deployment (SURD) bioprostheses in bicuspid aortic valves (BAV) are controversial. The aim of this study is to report the outcomes of patients undergoing aortic valve replacement (AVR) for BAV from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR). METHODS: Of the 4,636 patients who received primary isolated SURD-AVR between 2007 and 2018, 191 (4.1%) BAV patients underwent AVR with SURD valve. RESULTS: Overall 30-day mortality was 1.6%. The Intuity valve was implanted in 53.9% of cases, whereas the Perceval was implanted in 46.1%. Rate of stroke for isolated AVR was 4.2%. No case of endocarditis, thromboembolism, myocardial infarction, valve dislocation or structural valve deterioration was reported in the early phase. Rate of pacemaker implantation and moderate-severe aortic regurgitation (AR) were 7.9% and 3.7%, respectively. CONCLUSIONS: BAV is not considered a contraindication for the implantation of SURD valves. However, detailed information of aortic root geometry as well as the knowledge of some technical considerations are mandatory for a good outcome. 2020 Annals of Cardiothoracic Surgery. All rights reserved.
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