Aortic Valve Neocuspidization Procedure Provides Better Postoperative Outcomes When Compared to Rapid Deployement Aortic Valves

Authors

  • Kubilay Karabacak Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Emre Kubat Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Murat Kadan Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Serkan Asil Health Sciences University, Gülhane School of Medicine, Department of Cardiology, Ankara, Turkey
  • Gökhan Erol Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Tuna Demirkıran Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Serdar Fırtına Health Sciences University, Gülhane School of Medicine, Department of Cardiology, Ankara, Turkey
  • Suat Doganci Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
  • Mehmet Emin Ince Health Sciences University, Gülhane School of Medicine, Department of Anesthesiology, Ankara, Turkey
  • Cengiz Bolcal Health Sciences University, Gülhane School of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey

DOI:

https://doi.org/10.1532/hsf.5149

Keywords:

Ozaki Procedure, Aortic Valve Replacement, Repair, Rapid Deployment Aortic Valve System

Abstract

Background: The aim of this study was to compare the early results of rapid deployment aortic valves (RD-AVR) and aortic valve neocuspidization (AVNeo) techniques.

Methods: Between December 2019 to May 2022, 104 patients were operated on with aortic stenosis by RD-AVR (N = 52) and AVNeo (N = 52) techniques. Patients with isolated aortic valve stenosis and aortic stenosis concomittant with planned other cardiac surgeries were included.

Results: The mean age of patients in the RD-AVR and AVNeo groups were 67.4 ± 7.8 vs. 62.9 ± 8.7, respectively. Aortic cross-clamp time in the RD-AVR group was 56.7 ± 23.3 minutes, while it was 104.1 ± 27.9 minutes in the AVNeo group (P < 0.001). Cardiopulmonary bypass time in the RD-AVR group and in the AVNeo group was 89.8 ± 27.6 minutes and 141.8 ± 36.7 minutes, respectively (P < 0.001). Permanent pacemaker become necessary in four patients in the RD-AVR group secondary to type 2 AV block. Paravalvular leak was observed in six patients, who underwent RD-AVR, while grade 2 central aortic regurgitation was observed in one patient in the AVNeo group. Hospital mortality was 8% in the RD-AVR group and 6% in the AVNeo group (P = 0.696).

Conclusions: AVNeo procedure is a feasible technique in all age groups of patients with successful hemodynamic results in the early postoperative period and with the advantage of not requiring anticoagulants. It also can be applied with other cardiac surgical interventions.

References

Al-Sarraf N, Thalib L, Hughes A, et al. 2011. Cross-clamp time is an independent predictor of mortality and morbidity in low- and high-risk cardiac patients. International Journal of Surgery. 9:104–9.

Andreas M, Wallner S, Habertheuer A, et al. 2016. Conventional versus rapid-deployment aortic valve replacement: a single-centre comparison between the Edwards Magna valve and its rapid-deployment successor. Interact Cardiovasc Thorac Surg. 22:799-805.

Ashikhmina EA, Schaff HV, Dearani JA, et al. 2011. Aortic valve replacement in the elderly: determinants of late out- come. Circulation. 124:1070–8.

Barnhart GR, Accola KD, Grossi EA, et al. 2017. TRANSFORM (Multicenter Experience With Rapid Deployment Edwards INTUITY Valve System for Aortic Valve Replacement) US clinical trial: Performance of a rapid deployment aortic valve. J Thorac Cardiovasc Surg. 153:241-51.e2.

Borger MA, Moustafine V, Conradi L, et al. 2015. A randomized multicenter trial of minimally invasive rapid deployment versus conventional full sternotomy aortic valve replacement. Ann Thorac Surg. 99:17-25.

D'Onofrio A, Tessari C, Cibin G, et al. 2022. Clinical and Hemodynamic Outcomes of Rapid-Deployment Aortic Bioprostheses. Semin Thorac Cardiovasc Surg. 34:453-61.

Englberger L, Carrel TP, Doss M, et al. 2014. Clinical performance of a sutureless aortic bioprosthesis: five-year results of the 3f Enable long-term follow-up study. J Thorac Cardiovasc Surg. 148:1681-7.

Ensminger S, Fujita B, Bauer T, et al. 2018. Rapid Deployment Versus Conventional Bioprosthetic Valve Replacement for Aortic Stenosis. J Am Coll Cardiol. 71:1417-28.

Erdogan HB, Kayalar N, Ardal H, et al. 2006. Risk factors for requirement of permanent pacemaker implantation after aortic valve replacement. J Card Surg. 21:211-5; discussion 216-7.

Ferrari E, Roduit C, Salamin P, et al. 2017. Rapid- deployment aortic valve replacement versus standard bioprosthesis implantation. J Card Surg. 32:322-7.

Ferrari E, Siniscalchi G, Tozzi P, von Segesser L. 2015. Aortic Annulus Stabilization Technique for Rapid Deployment Aortic Valve Replacement. Innovations (Phila). 10:360-2.

Formica F, D'Alessandro S. 2018. Prosthesis-patient mismatch: Don't forget this match! J Thorac Cardiovasc Surg. 156:1353-4.

Karabacak K, Kadan M, Demirkıran T, Yasar AS, İInce ME, Bolcal C. 2022. Unrecognized indication for aortic valve neocuspidization: Patient with warfarin-induced Stevens-Johnson syndrome and toxic epidermal necrolysis. J Card Surg. 37:1733-1735.

Karabacak K, Kubat E, Erol G, et al. 2021. Aortic Neocuspidization with Autulogous Pericardium Initial Experience of Single Center. World Journal of Cardiovascular Surgery. 11:51-60.

Kocher AA, Laufer G, Haverich A, et al. 2013. One-year outcomes of the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial: a prospective multicenter study of rapid-deployment aortic valve replacement with the EDWARDS INTUITY Valve System. J Thorac Cardiovasc Surg. 145:110-5; discussion 115-6.

Lenders GD, Collas V, Hernandez JM, et al. 2014. Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study. Int J Cardiol. 176:771-5.

Meuris B, Ozaki S, Neethling W, et al. 2016. Trileaflet aortic valve reconstruction with a decellularized pericardial patch in a sheep model. J Thorac Cardiovasc Surg. 152:1167-74.

Mooney J, Sellers SL, Blanke P, et al. 2017. CT-Defined Prosthesis-Patient Mismatch Downgrades Frequency and Severity, and Demonstrates No Association With Adverse Outcomes After Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. 10:1578-87.

Ozaki S, Kawase I, Yamashita H, et al. 2011. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact Cardiovasc Thorac Surg. 12:550-3.

Ozaki S, Kawase I, Yamashita H, et al. 2014. A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium. J Thorac Cardiovasc Surg. 147:301-6.

Ozaki S, Kawase I, Yamashita H, Uchida S, Takatoh M, Kiyohara N. 2018. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. J Thorac Cardiovasc Surg. 155:2379-2387.

Reuthebuch O, Koechlin L, Schurr U, Grapow M, Fassl J, Eckstein FS. 2018. Aortic valve replacement using autologous pericardium: single centre experience with the Ozaki technique. Swiss Med Wkly. 148:w14591.

Schlömicher M, Haldenwang PL, Moustafine V, Bechtel M, Strauch JT. 2015. Minimal access rapid deployment aortic valve replacement: initial single-center experience and 12-month outcomes. J Thorac Cardiovasc Surg. 149:434-40.

Shrestha M, H€offler K, Koigeldiyev N, et al. 2013. Aortic valve replacement in geriatric patients with small aortic roots: are sutureless valves the future? Interact Cardiovasc Thorac Surg. 17:778-83.

Sohn SH, Jang MJ, Hwang HY, Kim KH. 2018. Rapid deployment or sutureless versus conventional bioprosthetic aortic valve replacement: A meta-analysis. J Thorac Cardiovasc Surg. 155:2402-12.

Vola M, Campisi S, Gerbay A, et al. 2015. Sutureless prostheses and less invasive aortic valve replacement: just an issue of clamping time? Ann Thorac Surg. 99:1518-23.

Wahlers TC, Andreas M, Rahmanian P, et al. 2018. Outcomes of a Rapid Deployment Aortic Valve Versus Its Conventional Counterpart: A Propensity-Matched Analysis. Innovations (Phila). 13:177-83.

Wahlers TC, Haverich A, Borger MA, et al. 2016. Early outcomes after isolated aortic valve replacement with rapid deployment aortic valve. J Thorac Cardiovasc Surg. 151:1639-47.

Yamamoto Y, Lino K, Shintani Y, et al. 2017. Comparison of Aortic Annulus Dimension After Aortic Valve Neocuspidization With Valve Replacement and Normal Valve. Semin Thorac Cardiovasc Surg. 29:143-9.

Published

2023-01-11

How to Cite

Karabacak, K., KUBAT, E. ., KADAN, M., ASİL, S. ., EROL, G., DEMİRKIRAN, T., FIRTINA, S., DOĞANCI, S., İNCE, M. E., & BOLCAL, C. . (2023). Aortic Valve Neocuspidization Procedure Provides Better Postoperative Outcomes When Compared to Rapid Deployement Aortic Valves. The Heart Surgery Forum, 26(1), E013-E019. https://doi.org/10.1532/hsf.5149

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