Clinical and Hemodynamic Results of Rapid Deployment Aortic Prostheses in Patients With Small Aortic Ring

Abstract

Objective: The Edwards Intuity valve is a rapid deployment biological aortic prosthesis. It is another option to treat aortic stenosis. It favors less aggressive approaches and shortens surgical times. Little is known about the hemodynamic and clinical behavior of their smaller sizes. We present our experience with Intuity prostheses Nos. 19 and 21. Methods: From September 2012 to May 2020, 122 Intuity prostheses were implanted, 54 (45%) were no. 19 or 21 (69% women, 76 (72-78) years). Results: One patient (1.8%) died in the hospital and six in the follow-up (3.4%). Mean pressure gradient at the discharge of 11.3 ± 4.3, at one year of 10.9 ± 3, and two years of 9.2 ± 3.5 mm Hg. Survival of 95% at 1 year and 83% at 5 years. Twenty-five patients (46%) had a prosthesis-patient mismatch, but with no impact on long-term survival (log-rank: 0.66). Three patients (6%) required a permanent pacemaker in the hospital. Patients with small Intuity prostheses did not present higher in-hospital mortality than patients with larger prostheses (1.8% vs 4.4%, p = 0.430) or higher mortality during follow-up (15% vs 10%; p = 0.430). Having a small prosthesis did not influence long-term survival (log-rank: 0.623). Conclusions: Edwards Intuity Aortic Prosthesis size 19-21 have shown excellent clinical and hemodynamic results with good medium-term survival. The patient prosthesis mismatch had no prognostic influence in this group. The Edwards Intuity aortic prosthesis is an option to consider in patients with a small aortic ring, especially if they are elderly.