Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study
Background: Aortic valve stenosis remains the most prevalent valvular pathology in Western countries. Rapid deployment bioprosthesis (RD) has emerged as a promising alternative to conventional valves for surgical aortic valve replacement (SAVR), particularly in elderly and high-risk patients. This s...
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MDPI AG
2025-05-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/5/191 |
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| author | Ricardo Ferreira Tiago R. Velho João Gonçalves André Sena Beatriz Draiblate Ana G. Almeida Ângelo Nobre Fausto Pinto |
| author_facet | Ricardo Ferreira Tiago R. Velho João Gonçalves André Sena Beatriz Draiblate Ana G. Almeida Ângelo Nobre Fausto Pinto |
| author_sort | Ricardo Ferreira |
| collection | DOAJ |
| description | Background: Aortic valve stenosis remains the most prevalent valvular pathology in Western countries. Rapid deployment bioprosthesis (RD) has emerged as a promising alternative to conventional valves for surgical aortic valve replacement (SAVR), particularly in elderly and high-risk patients. This study reports the short- and long-term outcomes of RD in patients with isolated aortic stenosis. Methods: A retrospective single-center analysis was conducted on 382 patients who underwent RD-AVR between 2014 and 2020. Data were collected from clinical files and national electronic databases. Primary outcomes included cardiopulmonary bypass (CPB) and cross-clamping (XC) times, postoperative complications, and long-term survival. Results: The mean age was 75.6 ± 5.9 years, with 29.8% of patients over 80 years old and a mean EuroSCORE II of 2.3 ± 1.5%. CPB and XC times were 36.7 ± 10.8 and 27.4 ± 8.1 min, respectively. Postoperative complications included acute kidney injury (AKI, 53.4%), de novo atrial fibrillation (31.9%), and high-grade/complete atrioventricular block with permanent pacemaker implantation (9.8%). In-hospital and 30-day mortality was 1.02% and 2.3%, respectively. The 5-year survival rate was 77%. At 6 months postoperatively, the mean transvalvular gradient was 11.1 ± 4.7 mmHg. At a median follow-up of 6.7 years, no cases of structural valve deterioration and only one case of endocarditis were reported. Conclusion: In this single-center study, RD in isolated AVR demonstrated favorable short- and long-term outcomes, including no structural valve deterioration at mid-term follow-up. These devices offer a safe and effective alternative to conventional SAVR, particularly in high-risk populations. |
| format | Article |
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| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-8a922246fd994c2f96d63f5da8141e882025-08-20T03:14:35ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-05-0112519110.3390/jcdd12050191Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective StudyRicardo Ferreira0Tiago R. Velho1João Gonçalves2André Sena3Beatriz Draiblate4Ana G. Almeida5Ângelo Nobre6Fausto Pinto7Department of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalCentro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, PortugalDepartment of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, PortugalCentro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, PortugalBackground: Aortic valve stenosis remains the most prevalent valvular pathology in Western countries. Rapid deployment bioprosthesis (RD) has emerged as a promising alternative to conventional valves for surgical aortic valve replacement (SAVR), particularly in elderly and high-risk patients. This study reports the short- and long-term outcomes of RD in patients with isolated aortic stenosis. Methods: A retrospective single-center analysis was conducted on 382 patients who underwent RD-AVR between 2014 and 2020. Data were collected from clinical files and national electronic databases. Primary outcomes included cardiopulmonary bypass (CPB) and cross-clamping (XC) times, postoperative complications, and long-term survival. Results: The mean age was 75.6 ± 5.9 years, with 29.8% of patients over 80 years old and a mean EuroSCORE II of 2.3 ± 1.5%. CPB and XC times were 36.7 ± 10.8 and 27.4 ± 8.1 min, respectively. Postoperative complications included acute kidney injury (AKI, 53.4%), de novo atrial fibrillation (31.9%), and high-grade/complete atrioventricular block with permanent pacemaker implantation (9.8%). In-hospital and 30-day mortality was 1.02% and 2.3%, respectively. The 5-year survival rate was 77%. At 6 months postoperatively, the mean transvalvular gradient was 11.1 ± 4.7 mmHg. At a median follow-up of 6.7 years, no cases of structural valve deterioration and only one case of endocarditis were reported. Conclusion: In this single-center study, RD in isolated AVR demonstrated favorable short- and long-term outcomes, including no structural valve deterioration at mid-term follow-up. These devices offer a safe and effective alternative to conventional SAVR, particularly in high-risk populations.https://www.mdpi.com/2308-3425/12/5/191aortic stenosisrapid deployment bioprosthesiselderly patientssurgical outcomes |
| spellingShingle | Ricardo Ferreira Tiago R. Velho João Gonçalves André Sena Beatriz Draiblate Ana G. Almeida Ângelo Nobre Fausto Pinto Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study Journal of Cardiovascular Development and Disease aortic stenosis rapid deployment bioprosthesis elderly patients surgical outcomes |
| title | Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study |
| title_full | Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study |
| title_fullStr | Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study |
| title_full_unstemmed | Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study |
| title_short | Isolated Rapid Deployment Aortic Valve Replacement in Patients with Aortic Stenosis: Single-Center Retrospective Study |
| title_sort | isolated rapid deployment aortic valve replacement in patients with aortic stenosis single center retrospective study |
| topic | aortic stenosis rapid deployment bioprosthesis elderly patients surgical outcomes |
| url | https://www.mdpi.com/2308-3425/12/5/191 |
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