Outcomes of Rapid Deployment Aortic Valve Replacement: Early Experience in Wellington Hospital

Abstract

Rapid deployment (RD) aortic valve replacement (AVR) using the Edwards Intuity Elite Valve System is a significant breakthrough in advancement in comparison with other current conventional sutured surgical AVR. This study aimed to analyse early experiences using this novel bioprosthesis. This 60-month prospective study, between July 2017 and July 2022, found that 59 patients had RD bioprosthesis implanted at this institution. Median follow-up period was 12 months. Baseline preoperative characteristics, isolated or concomitant procedures, valve prosthesis-related events, survival rates, and valve haemodynamics were evaluated. Primary endpoints were pacemaker implantation (PPM) rates, neurological events, paravalvular leaks, and early 30-day mortality rates. Secondary endpoints were reintervention, valve degeneration, arrhythmia, hospital stay, and readmission rates. Approximately 64% were males, with the mean age of 75±3 years. Isolated AVR was performed in 54% and the rest were concomitant procedures. Cardiopulmonary bypass and cross-clamping times were acceptable. In the isolated AVR group, the early PPM implantation rates were 5%, with 1.7% of patients experiencing a minor stroke event. One patient had paravalvular leak, which was moderate in haemodynamics. Mean gradient at discharge was 11±3 mmHg. There was no early inpatient mortality in the isolated AVR group, and the 30-day post-discharge mortality was zero. Re-operation rates and valve degeneration rates were zero. This study found promising and excellent early results in this small cohort of patients, validating for more usage of rapid deployment AVR in suitable patients.