Outcomes of rapid deployment aortic valve replacement with concomitant cardiac procedures.

Autor:	Gonzalez-Barbeito M; Department of Cardiac Surgery, Complexo Universitario Hospitalario de A Coruña, A Coruña, Spain., Arribas Leal JM; Department of Cardiac Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain., Jimenez Alfaro L; Department of Cardiac Surgery, Hospital Universitario de Navarra, Pamplona, Spain., Calderon Romero MP; Department of Cardiac Surgery, Fundación Jiménez Díaz/Clínica Nuestra Señora de la Concepción, Madrid, Spain., Carnero M; Department of Cardiac Surgery, Hospital Clínico de San Carlos, Madrid, Spain., Sarralde JA; Department of Cardiac Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain., Vazquez A; Department of Cardiac Surgery, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Canovas Lopez SJ; Department of Cardiac Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain., Aldamiz-Echevarria G; Department of Cardiac Surgery, Fundación Jiménez Díaz/Clínica Nuestra Señora de la Concepción, Madrid, Spain., Gutierrez F; Department of Cardiac Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain., Fernandez AL; Department of Cardiac Surgery, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, Galicia, Spain., Bautista-Hernandez V; William E. De Bakey Department of Surgery, Baylor College of Medicine/Christus Health Santa Rosa, San Antonio, TX, USA.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2023 Oct 31; Vol. 15 (10), pp. 5605-5612. Date of Electronic Publication: 2023 Oct 07.
DOI:	10.21037/jtd-23-191
Abstrakt:	Background: Rapid deployment aortic valve replacement (RD-AVR) has been recently introduced with encouraging results. Outcomes of isolated RD-AVR include good hemodynamic profile, facilitation of minimally invasive techniques, and reduction of surgical times. However, role of this prosthesis in concomitant surgery is not well known. Methods: In 2016, we formed a registry to monitor the introduction of this prosthesis, RApid Deployment Aortic Replacement (RADAR). We aim to report mid-term outcomes focusing on patients who had RD-AVR combined with other surgical procedures. Results: Between July 2012 and February 2021, 370 patients were included in this registry (mean age, 75.8±8.0 years; 64.32% male; mean EuroSCORE II, 3.5±2.8). Of these, 128 (34.59%) had concomitant procedures including myocardial revascularization surgery in 69 patients (53.91%), surgery on the ascending aorta in 34 (26.56%), and procedures on other valves in 10 patients (7.81%). There were no significant differences between the isolated AVR and concomitant AVR groups in postoperative complications, in-hospital mortality (4.72% vs. 3.32%, P=0.524), or hemodynamic behavior of these prostheses. Three-year survival was 83.73% and 89.89% in the isolated and concomitant AVR group respectively. There was no difference in survival between the two groups (log-rank test, P=0.4124). Conclusions: Our results support the safety and efficacy of the Edwards INTUITY valve system even in complex aortic valve disease with additional cardiac procedures. RD-AVR could become a useful tool for concomitant surgeries where surgical times are expected to be prolonged. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-191/coif). All authors report that this registry was supported by a research grant provided by Edwards Lifesciences. The authors have no other conflicts of interest to declare. (2023 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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