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Submitted: 15 Jul 2020
Accepted: 22 Nov 2020
ePublished: 30 Jan 2021
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J Cardiovasc Thorac Res. 2021;13(1): 23-27.
doi: 10.34172/jcvtr.2021.10
  Abstract View: 85
  PDF Download: 48

Original Article

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Adama Sawadogo 1,2* ORCID logo, An Vinh Bui-Duc 1,3, Nicolas D'Ostrevy 1, Lionel Camilleri 1, Kasra Azarnoush 1

1 Department of Cardiovascular, University Hospital of Clermont-Ferrand, France
2 Department of Cardiovascular and Thoracic Surgery, University Hospital of Tengandogo, Burkina Faso
3 Department of Cardiac Surgery, E Hospital of Hue, Vietnam
*Corresponding Author: Adama Sawadogo, Email: adamsaw2000@yahoo.fr

Abstract

Introduction: Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. In high-risk patients, conventional aortic valve replacement (C-AVR) carries high rates of morbidity and mortality. In the last few years, rapid-deployment valves (RDV) have been developed to reduce the surgical risks. In this work, we aimed to compare the mid-term outcomes of rapid-deployment AVR (RD-AVR) with those of the C-AVR in high-risk patients.

Methods: This retrospective case-control study identified 23 high-risk patients who underwent RD-AVR between 12/2015 to 01/2018. The study group was compared with a control group of 46 patients who were retrospectively selected from a database of 687 C-AVR patients from 2016 to 2017 which matched with the study group for age and Euro SCORE II.

Results: RD-AVR group presented more cardiovascular risk factors. Euro SCORE II was higher in the RD-AVR group (P=0.06). In the RD-AVR group, we observed significantly higher mean prosthetic size (P<0.001). In-hospital mortality was zero in RD-AVR group versus 2 deaths in C-AVR group. Hospital stay was longer in the RD-AVR group with statistical significance (P=0.03). In the group AVR with associated cardiac procedures, while comparing subgroups RD-AVR versus C-AVR, early mean gradient was lower in the first cited (P=0.02). The overall mean follow-up was 10.9 ± 4.3 months.

Conclusion: The RD-AVR technique is reliable and lead to positive outcomes. This procedure provides a much larger size with certainly better flow through the aortic root. It is an alternative to C-AVR in patients recognized to be surgically fragile.


Keywords: Aortic Valve Replacement, Rapid Deployment Aortic Valve, Calcified Aortic Stenosis, EuroSCORE II
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