Hemodynamic performance of INSPIRIS RESILIA aortic bioprosthesis for severe aortic stenosis: 2-year follow-up in Japanese cohort.

Abstract

The INSPIRIS RESILIA aortic bioprosthesis (Edwards Lifesciences LLC, Irvine, USA) was fixed in novel tissue preservation technology to ensure long-term durability. Hemodynamic performance after aortic valve replacement (AVR) for severe aortic stenosis (AS) has not been published in the Japanese cohort. Twenty-nine patients underwent AVR with INSPIRIS RESILIA bioprosthesis for severe AS between November 1, 2018 and December 31, 2020. The mean age was 75.1 ± 4.5years with 19 female patients. Body surface area was 1.58 ± 0.19 m2 and New York Heart Association functional class was 2.2 ± 0.5. Hemodynamic performance was assessed using follow-up transthoracic echocardiographic data collected at 3-6months, 1year and 2years. The mean follow-up time was 19.2 ± 7.2months, with a 100% follow-up rate. One patient died of postoperative heart failure. The preoperative mean and peak transvalvular pressure gradients (PGs) were 51.9 ± 18.4mmHg and 89.3 ± 34.9mmHg, respectively, and effective orifice area 0.72 ± 0.26 cm2. They improved at 10.2 ± 3.5mmHg (p < 0.0001), 19.3 ± 6.6mmHg (p < 0.0001) and 1.73 ± 0.47cm2 (p < 0.0001) at discharge. The mean transvalvular PG at 3-6months (n = 24), 1year (n = 25) and 2years (n = 15) was 11.2 ± 3.8mmHg (p < 0.0001), 11.1 ± 3.2mmHg (p < 0.0001) and 11.2 ± 3.3mmHg (p < 0.0001), respectively. Left ventricular mass index decreased from 123.0 ± 35.0g/m2 before surgery to 113.4 ± 35.0g/m2 (p = 0.0133) at discharge. It has dropped to 88.0 ± 25.0g/m2 (p = 0.0007) at 2years. Constrictive pericarditis caused heart failure in one patient. INSPIRIS RESILIA bioprosthesis showed improved hemodynamic performance in the early postoperative phase. There were fewer valve-related events observed.