Universität zu Köln

Wahlers, Thorsten C. W., Haverich, Axel, Borger, Michael A., Shrestha, Malakh, Kocher, Alfred A., Walther, Thomas, Roth, Matthias, Misfeld, Martin, Mohr, Friedrich W., Kempfert, Joerg, Dohmen, Pascal M., Schmitz, Christoph, Rahmanian, Parwis, Wiedemann, Dominik ORCID: 0000-0002-2055-8293, Duhay, Francis G. and Laufer, Guenther (2016). Early outcomes after isolated aortic valve replacement with rapid deployment aortic valve. J. Thorac. Cardiovasc. Surg., 151 (6). S. 1639 - 1648. NEW YORK: MOSBY-ELSEVIER. ISSN 1097-685X

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Abstract

Objective: Minimal access aortic valve replacement is associated with favorable clinical outcomes; however, several meta-analyses have reported significantly longer crossclamp times compared with a full sternotomy. We examined the procedural and early safety outcomes after isolated rapid deployment aortic valve replacement by surgical approach in patients enrolled in the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve trial. Methods: The Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve trial was a prospective, multicenter, single-arm study, with successful implants in 287 patients with aortic valve stenosis who underwent rapid deployment aortic valve replacement using the EDWARDS INTUITY Valve System (Edwards Lifesciences, Irvine, Calif). Patients were evaluated perioperatively for procedural times and technical success rates; at discharge, for hospital length of stay; and, at 30 days, for early adverse events. Results: Atotal of 158 patients underwent isolated aortic valve replacement through a full sternotomy (n = 71), upper hemisternotomy (n = 77), or right anterior thoracotomy (n = 10). Mean age at baselinewas 75.7 +/- 7.2 years. Mean aortic crossclamp and cardiopulmonary bypass times (minutes) were similar for full sternotomy and upper hemisternotomy, 43.5 +/- 32.5/71.6 +/- 41.8 and 43.1 +/- 13.1/69.6 +/- 19.1, respectively, and significantly longer for right anterior thoracotomy, 88.3 +/- 18.6/122.2 +/- 22.1 (P <. 000). Early adverse event rates were similar, and in-hospital mortality rates were low regardless of surgical approach. Conclusions: These data suggest that isolated rapid deployment aortic valve replacement through an upper hemisternotomy can lead to shorter crossclamp times than has been reported historically in the literature. This may facilitate minimal access aortic valve replacement by eliminating the issue of prolonged crossclamp times. Further, low in-hospital mortality and new permanent pacemaker implant rates were observed regardless of surgical approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wahlers, Thorsten C. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haverich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Borger, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shrestha, Malakh UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Alfred A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Misfeld, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohr, Friedrich W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kempfert, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Pascal M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiedemann, Dominik UNSPECIFIED orcid.org/0000-0002-2055-8293 UNSPECIFIED Duhay, Francis G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Laufer, Guenther UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-274649
DOI:	10.1016/j.jtcvs.2015.12.058
Journal or Publication Title:	J. Thorac. Cardiovasc. Surg.
Volume:	151
Number:	6
Page Range:	S. 1639 - 1648
Date:	2016
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1097-685X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERMANENT PACEMAKER IMPLANTATION; RIGHT ANTERIOR MINITHORACOTOMY; SUTURELESS BIOPROSTHESIS; MULTICENTER; STERNOTOMY; OPERATIONS; TRIAL; MINISTERNOTOMY; PREDICTORS; EXPERIENCE Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27464