TY - JOUR
T1 - Operative outcome of patients at low, intermediate, high and 'very high' surgical risk undergoing isolated aortic valve replacement with sutureless and rapid deployment prostheses
T2 - results of the SURD-IR registry
AU - Santarpino, Giuseppe
AU - Berretta, Paolo
AU - Fischlein, Theodor
AU - Carrel, Thierry P.
AU - Teoh, Kevin
AU - Misfeld, Martin
AU - Savini, Carlo
AU - Kappert, Utz
AU - Glauber, Mattia
AU - Villa, Emmanuel
AU - Meuris, Bart
AU - Mignosa, Carmelo
AU - Albertini, Alberto
AU - Martinelli, Gianluca
AU - Folliguet, Thierry A.
AU - Shrestha, Malak
AU - Solinas, Marco
AU - Laufer, Günther
AU - Phan, Kevin
AU - Yan, Tristan
AU - Di Eusanio, Marco
PY - 2019/7/1
Y1 - 2019/7/1
N2 - OBJECTIVES: The ideal strategy for the treatment of severe aortic valve stenosis in patients of varying risk categories has become a debated topic in the last years: should the transcatheter or surgical approach be adopted? The aim of this study was to evaluate the outcomes of low-, intermediate-, high- and very high-risk patients undergoing sutureless, rapid deployment aortic valve replacement.METHODS: From 2007 to 2017, data on a total of 3651 patients were collected from the Sutureless and Rapid Deployment Aortic Valve Replacement International Registry (SURD-IR). Of these, 2057 patients who underwent primary isolated aortic valve replacement were considered for this analysis and classified as being at low (EuroSCORE <5; n = 500), intermediate (EuroSCORE 5-10; n = 901), high (EuroSCORE 11-20; n = 500) and very high (EuroSCORE >20; n = 156) preoperative risk.RESULTS: Overall, a less invasive approach was used in 74.1% of patients and represented the most frequent (>50%) approach in all risk categories. The Perceval prosthesis was used more frequently than other devices, especially in patients at high and very high risk. Hospital mortality was 1.6%, 0.8%, 1.9% and 2.7% in low-, intermediate-, high- and very high-risk patients, respectively, with no significant differences among subgroups. Similarly, postoperative complication rates were similar across the different risk categories.CONCLUSIONS: Surgical aortic valve replacement using sutureless, rapid deployment biological valve prostheses is associated with excellent results and represents a safe and effective treatment option for patients with severe aortic valve stenosis. This seems to be particularly true in patients with a higher risk profile.
AB - OBJECTIVES: The ideal strategy for the treatment of severe aortic valve stenosis in patients of varying risk categories has become a debated topic in the last years: should the transcatheter or surgical approach be adopted? The aim of this study was to evaluate the outcomes of low-, intermediate-, high- and very high-risk patients undergoing sutureless, rapid deployment aortic valve replacement.METHODS: From 2007 to 2017, data on a total of 3651 patients were collected from the Sutureless and Rapid Deployment Aortic Valve Replacement International Registry (SURD-IR). Of these, 2057 patients who underwent primary isolated aortic valve replacement were considered for this analysis and classified as being at low (EuroSCORE <5; n = 500), intermediate (EuroSCORE 5-10; n = 901), high (EuroSCORE 11-20; n = 500) and very high (EuroSCORE >20; n = 156) preoperative risk.RESULTS: Overall, a less invasive approach was used in 74.1% of patients and represented the most frequent (>50%) approach in all risk categories. The Perceval prosthesis was used more frequently than other devices, especially in patients at high and very high risk. Hospital mortality was 1.6%, 0.8%, 1.9% and 2.7% in low-, intermediate-, high- and very high-risk patients, respectively, with no significant differences among subgroups. Similarly, postoperative complication rates were similar across the different risk categories.CONCLUSIONS: Surgical aortic valve replacement using sutureless, rapid deployment biological valve prostheses is associated with excellent results and represents a safe and effective treatment option for patients with severe aortic valve stenosis. This seems to be particularly true in patients with a higher risk profile.
KW - Aortic valve replacement
KW - Aortic valve stenosis
KW - Rapid deployment aortic valve
KW - Sutureless aortic valve
UR - http://www.scopus.com/inward/record.url?scp=85068374171&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezy477
DO - 10.1093/ejcts/ezy477
M3 - Article
C2 - 30689828
SN - 1010-7940
VL - 56
SP - 38
EP - 43
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 1
ER -