Operative outcome of patients at low, intermediate, high and 'very high' surgical risk undergoing isolated aortic valve replacement with sutureless and rapid deployment prostheses

results of the SURD-IR registry

Giuseppe Santarpino, Paolo Berretta*, Theodor Fischlein, Thierry P. Carrel, Kevin Teoh, Martin Misfeld, Carlo Savini, Utz Kappert, Mattia Glauber, Emmanuel Villa, Bart Meuris, Carmelo Mignosa, Alberto Albertini, Gianluca Martinelli, Thierry A. Folliguet, Malak Shrestha, Marco Solinas, Günther Laufer, Kevin Phan, Tristan Yan & 1 others Marco Di Eusanio

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume56
Issue number1
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • Aortic valve replacement
  • Aortic valve stenosis
  • Rapid deployment aortic valve
  • Sutureless aortic valve

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