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Mid-term outcomes of rapid deployment aortic prostheses in patients with small aortic annulus
Authors:José   M Arribas-Leal,José   Miguel Rivera-Caravaca,Ramó  n Aranda-Domene,José   A Moreno-Moreno,Dolores Espinosa-Garcia,Antonio Jimenez-Aceituna,Joaquí  n Perez-Andreu,Rubé  n Taboada-Martin,Daniel R Saura-Espin,Sergio J Canovas-Lopez
Affiliation:1. Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain;2. Department of Cardiology, Virgen de la Arrixaca University Hospital, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
Abstract:Open in a separate windowOBJECTIVESThe Edwards Intuity valve is a rapid deployment aortic prosthesis that favours less invasive approaches. However, evidence about the clinical behaviour of their smaller sizes is scarce. Herein, we studied haemodynamic behaviours and clinical outcomes of small Intuity prostheses (19–21 mm) in comparison to larger Intuity prostheses (>21 mm).METHODSThis is an observational study including patients implanted with an Edwards Intuity rapid deployment aortic prosthesis. Patients with prosthesis sizes 19–21 and >21 mm were included. Baseline and perioperative variables, as well as adverse events during the follow-up were recorded and compared between groups.RESULTSA total of 122 patients (37% female, mean age 75 ± 4.5 years) were included, of whom 54 (45%) were implanted with a small prosthesis and 68 (55%) with a prosthesis >21 mm. There were no significant differences between patients with small Intuity prostheses and patients with larger prostheses regarding in-hospital mortality (2% vs 4%, P = 0.43) or mortality during the follow-up (3.41 vs 2.45 per 100 patients-years; P = 0.58). Survival in the small Intuity valve group was 95% at 1 year and 83% at 6 years, whereas in the larger Intuity valve group was 96% at 1 year and 78% at 6 years. The presence of a small prosthesis did not influence mid-term survival (log-rank P-value = 0.62).CONCLUSIONSThis study showed good clinical performance of Intuity aortic prostheses with appropriate mid-term survival in patients with the small aortic annulus. Thus, the Edwards Intuity rapid deployment aortic prosthesis may be considered as a potential option in patients with the small aortic annulus.
Keywords:Aortic stenosis, Biological prostheses, Rapid deployment aortic prostheses, Prosthesis–  patient mismatch
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