Early and Mid-Term Results of Rapid Deployment Valves: The Intuity Italian Registry (INTU-ITA)

Massimo Massetti, Daniele Maselli, Carlo Maria De Filippo, Augusto D'Onofrio, Chiara Tessari, Claudia Filippini, Lorenzo Bagozzi, Marco Diena, Francesco Alamanni, Ugolino Livi, Marco Di Eusanio, Carmelo Mignosa, Claudio Russo, Mauro Rinaldi, Roberto Di Bartolomeo, Loris Salvador, Carlo Antona, Ruggero De Paulis, Giampaolo Luzi, Ottavio AlfieriMichele Portoghese, Francesco Musumeci, Uberto Bortolotti, Gino Gerosa

Risultato della ricerca: Contributo in rivistaArticolo in rivista

13 Citazioni (Scopus)

Abstract

Background: Rapid deployment bioprostheses (RDBs) have been recently introduced into clinical practice for the treatment of severe aortic valve stenosis. The aim of this retrospective multicenter study was to assess early and mid-term clinical and hemodynamic outcomes of patients undergoing RDB implantation. Methods: Data from a national registry that included patients who underwent isolated or combined aortic valve replacement with RDB in Italy were analyzed. Definitions of the European System for Cardiac Operative Risk Evaluation were used for preoperative variables and updated definitions from the Valve Academic Research Consortium were used for postoperative outcomes assessment. Univariable and multivariable analyses were performed to identify independent predictors of mortality. Follow-up was performed with clinical and echocardiographic examinations at each study site and, if this was not possible, through telephonic interviews. The Kaplan-Meier method was used for survival analysis. Results: A total of 902 patients (December 2012 through November 2017) from 20 national centers were included in the registry. Device success was 95.9%, and 30-day all-cause mortality was 2.8%. Postoperative pacemaker implantation was needed in 63 patients (6.9%). At discharge, peak and mean transaortic gradients were 19 ± 7 mm Hg and 11 ± 4 mm Hg, respectively. Mild and moderate aortic regurgitation were found in 71 patients (8.2%) and in 10 patients (1.2%), respectively. Median follow-up time was 357 days (interquartile range: 103 to 638 days). Survival at 4 years was 86% ± 1%. Preoperative conduction disturbances and history of previous myocardial infarction were independently associated with mortality. Conclusions: Aortic RDBs provide good early and mid-term clinical and hemodynamic outcomes. These devices may be considered as a reasonable alternative to conventional bioprostheses, especially in minimally invasive and combined operations.
Lingua originaleEnglish
pagine (da-a)1742-1749
Numero di pagine8
RivistaANNALS OF THORACIC SURGERY
Volume106
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

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