Minimally Invasive Redo Aortic Valve Replacement: Results From a Multicentric Registry (SURD-IR) Journal Articles uri icon

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abstract

  • BACKGROUND: Reoperation for aortic valve replacement can be challenging and is usually associated with an increased risk for complications and mortality. The study aim was to report the results of a multicenter cohort of patients who underwent minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis. METHODS: From 2007 to 2018 data from 3651 patients were retrospectively collected from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry. Of them, 63 patients who had previously undergone cardiac surgery represented the study population. In-hospital clinical and echocardiographic outcomes were recorded. RESULTS: Mean age of the selected 63 patients was 75.3 ± 7.8 years and logistic EuroSCORE 10.1. Surgery was performed by ministernotomy in 43 patients (68.3%) and by anterior right thoracotomy in 20 (31.7%); 31 patients (49.2%) received the Perceval valve (Livanova PLC, London, UK) and 32 (50.8%) the Intuity valve (Edwards Lifesciences, Irvine, CA). Mean cross-clamp time was 57.8 ± 23.2 minutes and cardiopulmonary bypass time 95.0 ± 34.3 minutes. Neither conversion to full sternotomy nor in-hospital deaths occurred. Postoperative events were ischemic cerebral events in 3 patients (4.8%), need for pacemaker implantation in 2 (3.6%), bleeding requiring reoperation in 5 (8.9%), and dialysis in 1 (1.6%). Median intensive care unit stay was 1 day, and median length of hospital stay was 10 days. On echocardiographic evaluation 1 patient showed a significant postoperative aortic regurgitation. CONCLUSIONS: Minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis is a safe and feasible treatment strategy, resulting in fast recovery and improved postoperative outcome with no mortality and an acceptable complication rate.

authors

  • Santarpino, Giuseppe
  • Berretta, Paolo
  • Kappert, Utz
  • Teoh, Kevin
  • Mignosa, Carmelo
  • Meuris, Bart
  • Villa, Emmanuel
  • Albertini, Alberto
  • Carrel, Thierry P
  • Misfeld, Martin
  • Martinelli, Gianluca
  • Phan, Kevin
  • Miceli, Antonio
  • Folliguet, Thierry
  • Shrestha, Malak
  • Solinas, Marco
  • Andreas, Martin
  • Savini, Carlo
  • Yan, Tristan
  • Fischlein, Theodor
  • Di Eusanio, Marco

publication date

  • August 2020

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