Expanding Indications of Rapid Deployment Aortic Valve Replacement: Five-year Outcomes from A Single-center Experience
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0130
Submission Type:
Abstract Submission
Authors:
SEON YONG BAE (1), Kyung Hwan Kim (1), Suk Ho Sohn (1), Yongwoo Chung (1), Yoonjin Kang (1), Ji Seong Kim (1), Jae Woong Choi (1)
Institutions:
(1) Seoul National University Hospital, Seoul, Seoul
Submitting Author:
Seon Yong Bae
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Seoul National University Hospital
Seoul National University Hospital
Co-Author(s):
Kyung Hwan Kim
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Seoul National University Hospital
Seoul National University Hospital
Suk Ho Sohn
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Seoul National University Hospital
Seoul National University Hospital
Yongwoo Chung
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Seoul National University Hospital
Seoul National University Hospital
Yoonjin Kang
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Seoul National University Hospital
Seoul National University Hospital
Ji Seong Kim
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Seoul National University Hospital
Seoul National University Hospital
Jae Woong Choi
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Seoul National University Hospital
Seoul National University Hospital
Presenting Author:
Seon Yong Bae
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Seoul National University Hospital
Seoul National University Hospital
Abstract:
Objective: Rapid deployment aortic valve replacement (RD[AVR]) has been widely used for the treatment of aortic valve stenosis. However, there is limited evidence on the use of the RD valve in aortic valve diseases other than aortic stenosis. This study evaluated the 5-year outcomes of RDAVR for various aortic valve diseases in a single center.
Methods: Overall 344 patients who underwent AVR using INTUITY valve in our institution between 2016 and 2023 were included. Early clinical outcomes, mid-term clinical outcomes and hemodynamic outcomes from early postoperative period to postoperative 5 years were also investigated. Median follow-up duration was 28.6 months (maximum 86.4 months).
Results: Mean age was 68.9 ± 9.8 years, and 46.2% were female. There were 176 bicuspid valves (51.2%), 20 pure aortic regurgitations (5.8%), and 4 infective endocarditis (1.2%). Isolated RDAVR was performed in 90 patients (26.2%), and concomitant procedures were performed in 254 patients (73.8%), including aorta surgery (48.8%), mitral valve surgery (20.3%), arrhythmia surgery (9.0%), tricuspid valve surgery (7.0%), and coronary artery bypass grafting (5.5%). Operative mortality was observed in 11 patients (3.2%), and permanent pacemaker implantation was required in 5 patients (1.5%) during the early postoperative period. The 1-year and 5-year survival rates were 94.2% and 84.0%, respectively, and freedom from aortic valve-related events were 89.0% and 77.9% in 1 year and 5 years, respectively. No deterioration of valve hemodynamics in every size of the prostheses was observed up to 5-year echocardiographic evaluation. Mean pressure gradients of the prostheses were 9.9 ± 4.3 mmHg and 9.4 ± 3.8 mmHg at 1 year and 5 years, respectively.
Conclusions: The RD valve can serve as a reliable bioprosthesis for both isolated and concomitant AVRs for various aortic valve diseases, including bicuspid valve, pure aortic regurgitation, and infective endocarditis. Excellent clinical and hemodynamic results would be guaranteed up to 5 years.
Methods: Overall 344 patients who underwent AVR using INTUITY valve in our institution between 2016 and 2023 were included. Early clinical outcomes, mid-term clinical outcomes and hemodynamic outcomes from early postoperative period to postoperative 5 years were also investigated. Median follow-up duration was 28.6 months (maximum 86.4 months).
Results: Mean age was 68.9 ± 9.8 years, and 46.2% were female. There were 176 bicuspid valves (51.2%), 20 pure aortic regurgitations (5.8%), and 4 infective endocarditis (1.2%). Isolated RDAVR was performed in 90 patients (26.2%), and concomitant procedures were performed in 254 patients (73.8%), including aorta surgery (48.8%), mitral valve surgery (20.3%), arrhythmia surgery (9.0%), tricuspid valve surgery (7.0%), and coronary artery bypass grafting (5.5%). Operative mortality was observed in 11 patients (3.2%), and permanent pacemaker implantation was required in 5 patients (1.5%) during the early postoperative period. The 1-year and 5-year survival rates were 94.2% and 84.0%, respectively, and freedom from aortic valve-related events were 89.0% and 77.9% in 1 year and 5 years, respectively. No deterioration of valve hemodynamics in every size of the prostheses was observed up to 5-year echocardiographic evaluation. Mean pressure gradients of the prostheses were 9.9 ± 4.3 mmHg and 9.4 ± 3.8 mmHg at 1 year and 5 years, respectively.
Conclusions: The RD valve can serve as a reliable bioprosthesis for both isolated and concomitant AVRs for various aortic valve diseases, including bicuspid valve, pure aortic regurgitation, and infective endocarditis. Excellent clinical and hemodynamic results would be guaranteed up to 5 years.
Aortic Symposium:
Natural History/Follow-Up
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