Do rapid deployment aortic valves improve outcomes compared with surgical aortic valve replacement?

A best evidence topic was written according to a structured protocol. The question addressed was ‘In patients requiring an aortic valve replacement, are rapid deployment aortic valve systems better than conventional aortic valve prostheses in terms of mortality, morbidity and/or valve function?’ A total of 508 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The rapid deployment valves (RDVs) implanted in these studies include balloon expandable [Intuity (Edwards Lifesciences, CA, USA) and 3F Enable (Medtronic, MN, USA)] and self-expanding [Perceval (Sorin, Saluggia, Italy)] stented bioprostheses. Available data from these studies demonstrate that rapid deployment valves are invariably associated with shorter aortic cross-clamp times (30–56 vs 49–88 min). Despite this, postoperative mortality (0–5.8 vs 0–6%), ICU (1–3 vs 0.9–2.8 days) and hospital length of stay (6–14.1 vs 6–15.9 days) are similar compared with conventional aortic valve replacement (AVR). However, reduced postoperative bleeding (328 vs 564 ml), blood transfusion requirements (1.4 vs 2.4 units), ventilation time (4.9–9.5 vs 7–16.6 h) and renal injury (5.3 vs 14.7%) have been demonstrated with RDVs indicating possible clin...
Source: Interactive CardioVascular and Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Basic research vascular Adult Cardiac Source Type: research