Rapid Deployment Aortic Valve Replacement: Outcomes after More Than 500 Implants

Objectives: Rapid deployment aortic valve replacement (RDAVR) was mainly developed to facilitate minimally invasive surgery and to reduce procedural times. Herein, we report 1 year outcomes of more than 500 patients undergoing RDAVR with the EDWARDS INTUITY valve system.

Methods: A total of 510 patients underwent rapid deployment AVR between March 2012 and September 2017. Isolated aortic valve replacement was performed in 270 cases, AVR with concomitant procedures in 240 cases. Procedural, early (<30 days) and late (>30 days) outcomes were collected. Follow-up examination was performed after 12 months. The median follow-up time was 12 months.

Results: The mean age was 74.3 ± 6.9 years, and the mean logistic EuroSCORE was 12.3 ± 4.3%. Early all-cause mortality was 3.1% (n = 16). Cumulative survival after 12 months was 91.9 ± 2.2%. Cross-clamp time for isolated AVR was 37.3 ± 8.9 minutes and 87 ± 7.4 minutes for AVR with concomitant procedures. At discharge, the mean effective orifice was 1.8 ± 0.2 cm² with a mean gradient of 9.3 ± 0.8 cm². New pacemaker implantation rate was 7.8% (n = 40). No case of structural degeneration was seen. Endocarditis occurred in three patients (0.6%).

Conclusion: RDAVR can be performed safely with low complication rates and good hemodynamic results. Therefore, the relevance in aortic valve surgery can be stressed.