Rapid Deployment Aortic Valve Replacement with the Perceval S and Intuity Elite

Abstract

Background Rapid deployment aortic valve replacement (RDAVR) has emerged as an alternative to conventional aortic valve replacement. This single-center study retrospectively analyzed clinical outcomes and hemodynamic performance of the Perceval S (LivaNova) and Intuity Elite (Edwards LifeSciences) rapid deployment valves (RDVs) in a propensity score matched patient cohort.

Methods A total of 372 consecutive patients with symptomatic aortic valve stenosis underwent RDAVR between 2012 and 2018 at our institution. The Intuity Elite (INT group) and Perceval S (PER group) were implanted in 251 and 121 patients, respectively. After 1:1 propensity score matching for relevant preoperative comorbidities, 107 patient pairs were compared with respect to relevant perioperative data including hemodynamic parameter, postoperative pacemaker implantation, and 30-day all-cause mortality.

Results Propensity score matching resulted in balanced characteristics between groups. Cardiopulmonary bypass and aortic cross-clamp time did not differ between groups, but more patients in the INT group received coronary artery bypass grafting compared with the PER group (56 vs. 42%; p = 0.055). Thirty-day mortality (4.7 vs. 2.2%) and need for permanent pacemaker implantation (7 versus 4.4%) were comparable between the INT and PER groups for isolated AVR and also for combined procedures, respectively. Cerebrovascular events showed comparable low rates for both RDVs (INT group [1.9%] vs. PER group [2.8%]). Indexed effective orifice area was higher in the INT group (0.90 vs. 0.82 cm²/m²) and coupled to a lower peak (17 ± 7 vs. 22 ± 8) and mean (10 ± 5 vs. 12 ± 4) pressure gradients compared with the PER group.

Conclusions Our propensity score analysis in AVR patients showed good hemodynamic characteristics with comparable 30-day mortality rate and complications rates for both investigated RDVs.

Keywords

aortic valve and root - heart valve surgery - cardiac - minimally invasive surgery

Authors' Contribution

O. L. and S. G. contributed to study design, data collection, data analysis and interpretation, and writing of the manuscript; both authors contributed equally to this work. P. R. and K. E. contributed to data collection and data analysis/interpretation. I. D. and G. S. contributed to collection of data and literature search. M. Z. and N. M. contributed to data analysis and interpretation. Y. C. and T. W. contributed to data analysis and interpretation, review, and correction of the manuscript.

Note

Part of the presented data in this paper was presented at the 2019 Annual European Association for Cardio-Thoracic Surgery Meeting, Lisbon, Portugal.

^* Both authors contributed equally to this work.

Publikationsverlauf

Eingereicht: 26. Mai 2020

Angenommen: 17. August 2020

Artikel online veröffentlicht:
25. Oktober 2020

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