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Open Access 01-12-2017 | Research article

Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy

Authors: Constanze Bening, Khaled Hamouda, Mehmet Oezkur, Christoph Schimmer, Ina Schade, Armin Gorski, Ivan Aleksic, Rainer Leyh

Published in: Journal of Cardiothoracic Surgery | Issue 1/2017

Abstract

Background

There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT.

Methods

Sixty-eight patients (mean age 76 ± 6 years, 32% females) underwent RAT-AVR between 9/2013 and 7/2015. According to the valve type implanted the patients were divided into two groups. In 43 patients (R-group; mean age 74.1 ± 6.6 years) a rapid deployment valve system (Edwards Intuity, Edwards Lifesciences Corp; Irvine, Calif) and in 25 patients (C-group; mean age 74.2 ± 6.6 years) a conventional stented biological aortic valve was implanted.

Results

Aortic cross-clamp (42.1 ± 12 min vs. 68.3 ± 20.3 min; p < 0.001) and bypass time (80.4 ± 39.3 min vs. 106.6 ± 23.2 min; p = 0.001) were shorter in the rapid deployment group (R-group). We observed no differences in clinical outcome. Postoperative gradients (R-group: max gradient, 14.3 ± 8 mmHg vs. 15.5 ± 5 mmHg (C-group), mean gradient, 9.2 ± 1.7 mmHg (R-group) vs. 9.1 ± 2.3 mmHg (C-group) revealed no differences. However, larger prostheses were implanted in C-group (25 mm; IQR 23–27 mm vs. 23 mm; IQR 21–25; p = 0.009).

Conclusions

Our data suggest that the rapid deployment aortic valve system reduced cross clamp and bypass time in patients undergoing RAT-AVR with similar hemodynamics as with larger size stented prosthesis. However, larger studies and long-term follow-up are mandatory to confirm our findings.

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Title: Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy
Authors: Constanze Bening
Khaled Hamouda
Mehmet Oezkur
Christoph Schimmer
Ina Schade
Armin Gorski
Ivan Aleksic
Rainer Leyh
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2017
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-017-0598-0

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Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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