Rapid Deployment Aortic Valves: Intermediate-term Clinical and Hemodynamic Results

Abstract

Objective: Rapid deployment aortic valves appeared ten years ago to treat aortic stenosis. The Edwards Intuity Valve System is a biological prosthesis based on the Edwards Magna valve with an infra-annular framework. We present the short and intermediate-term clinical and hemodynamic results obtained with this biological prosthesis. Methods: One hundred twenty-two patients (63% male, 75 ± 4.5 years) with aortic stenosis (mean preoperative gradient of 49.4 ± 12.5 mm Hg) received an Edwards Intuity prosthesis between September 2012 and May 2020. They were included in a prospective database that collected different variables. The mean follow-up was 38 ± 23 months. Results: Hospital mortality was 3.3%. Survival at one, three, and seven years was 95%, 89%, and 84%, respectively. Upper hemisternotomy was used in 81 patients (66%). The median times of myocardial ischemia and extracorporeal circulation for the entire series were 39 (33-50) minutes and 58 (47-73) minutes. Average gradients at discharge, one year and two years were 10 ± 4 mm, 9 ± 3 mm, and 8.7 ± 4 mm Hg. Eight patients (7%) required pacemakers in the postoperative period. Two patients (0.52%) underwent surgery for endocarditis and another (0.26%) underwent surgery for a periprosthetic leak. Conclusions: The Edwards Intuity valve system presents good short- and intermediate-term clinical and hemodynamic results. These aortic prostheses can be considered an alternative to conventional prostheses, especially in minimal access surgery and complex interventions.