Early Results after Aortic Valve Replacement Using Last Generation Bioprosthetic Aortic Valve
DOI:
https://doi.org/10.1532/hsf.4189Keywords:
aortic valve replacement, young patients, new aortic valve bioprosthesisAbstract
Introduction: Few data are available about the newest generation surgical bioprosthesis. We aimed to evaluate early clinical and hemodynamic outcomes after using the INSPIRIS RESILIA aortic valve (Edwards Lifesciences, Irvine, California, USA).
Methods: Between July 2018 and April 2021, 80 patients underwent aortic valve replacement receiving the INSPIRIS RESILIA aortic valve at our institution. Primary outcomes were the composite of early mortality, stroke, and myocardial infarction. Secondary outcomes were hemodynamic performances of the valve, paravalvular leakage, and new pacemaker implantation.
Results: The mean age of the study population was 60.6 ± 8.3 years. The mean Society of Thoracic Surgery-Predicted Risk of Mortality score was 2.9 ± 1.7%. In 43.7% of the patients, concomitant surgery was performed. The in-hospital
mortality, all-stroke, and myocardial infarction rates were 2.5%, 1.2%, and 1.2%, respectively. No valve was explanted and no redo was performed. The mean postoperative trans-prosthetic gradient at discharge was 10.2 ± 4.1 mm Hg. There was no need for new pacemaker implantation. We registered only two cases with minimal (trace) paravalvular leakage.
Conclusion: The use of the INSPIRIS RESILIA aortic valve in a young, low-risk population is safe and associated with very good early clinical and hemodynamic outcomes.
References
Bartuś K, Litwinowicz R, Bilewska A, et al. 2021. Final 5-year outcomes following aortic valve replacement with a RESILIA™ tissue bioprosthesis. Eur J Cardiothorac Surg. Jan 29;59(2):434-441.
Bartuś K, Litwinowicz R, Kuśmierczyk M, et al. 2018. Primary safety and effectiveness feasibility study after surgical aortic valve replacement with a new generation bioprosthesis: one-year outcomes.Kardiol Pol. 76(3):618-624.
Kappetein AP, Head SJ, Généreux P, et al. 2013. Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document. J Thorac Cardiovasc Surg. Jan;145(1):6-23.
Mack MJ, Leon MB, Thourani, et al. 2019. PARTNER 3 Investigators. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. N Engl J Med. May 2;380(18):1695-1705.
Malik AH, Yandrapalli S, Zaid S, et al. 2020. Valve-in-Valve Transcatheter Implantation Versus Redo Surgical Aortic Valve Replacement. Am J Cardiol. Feb 8. pii:S0002-9149(20)30115-6.
Nishimura RA, Otto CM, Bonow RO, et al. 2017. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 135(25):e1159–95.
Pibarot P, Salaun E, Dahou A, et al. 2020. PARTNER 3 Investigators. Echocardiographic Results of Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: The PARTNER 3 Trial. Circulation. May 12;141(19):1527-1537.
Puskas JD, Bavaria JE, Svensson LG, et al. 2017. COMMENCE Trial Investigators.
The COMMENCE trial: 2-year outcomes with an aortic bioprosthesis with RESILIA tissue.
Eur J Cardiothorac Surg. Sep 1;52(3):432-439.
Shala M and Niclauss L. 2020. Early results of the Resilia Inspiris aortic valve in the old age patients - a retrospective comparison with the Carpentier Edwards Magna Ease.J Cardiovasc Thorac Res. 12(3):222-226.
Shang H, Claessens SM, Tian B, Wright GA. 2017. Aldehyde reduction in a novel pericardial tissue reduces calcification using rabbit intramuscular model. J Mater Sci Mater Med. 28:16.
