AUTHOR=Öner Alper , Hemmer Christoph , Alozie Anthony , Löser Benjamin , Dohmen Pascal M. 

TITLE=Introduction of the Rapid Deployment Aortic Valve System Use in Elderly Patients With Endocarditis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.774189

DOI=10.3389/fcvm.2022.774189

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>The rapid-deployment valve system (RDVS) was introduced to facility minimally invasive aortic valve replacement. In this study we evaluate the potential benefits of RDVS in elderly high-risk patients with endocarditis of the aortic valve.</p></sec><sec><title>Materials and Methods</title><p>Since the introduction of RDVS in our institution in December 2017 through October 2021, EDWARDS INTUITY rapid-deployment prosthesis (Model 8300A, Edwards Lifesciences, Irvine, CA, USA) has been implanted in a total of 115 patients for different indications by a single surgeon. Out of one-hundred and fifteen cases of RDVS implantation, seven patients with a median age of 77 yrs. (range 62–84yrs.), suffered from active infective endocarditis of the aortic valve. The median EuroSCORE II of these highly selected patient cohort was 77% (range 19–80%). Patient data were evaluated perioperatively including intra-operative data as well as in-hospital morbidity/mortality and follow-up after discharge from hospital.</p></sec><sec><title>Results</title><p>Three patients underwent previous cardiac surgery. Concomitant procedures were performed in six patients including, ascending aorta replacement (<italic>n</italic> = 3), mitral valve repair (<italic>n</italic> = 1), pulmonary valve replacement (<italic>n</italic> = 1), bypass surgery (<italic>n</italic> = 1), left atrial appendix resection (<italic>n</italic> = 1) and anterior mitral valve repair (<italic>n</italic> = 1). Median aortic cross-clamp and cardiopulmonary bypass time was 56 min (range 29–122 min) and 81 min (range 45–162 min.), respectively. Post-operative complications in these elderly high-risk patients were atrial fibrillation (<italic>n</italic> = 3) and re-exploration for pericardial effusion (<italic>n</italic> = 1). One pacemaker implantation was required on postoperative day 6 due to sick sinus syndrome. There was one in-hospital death (14%) and one during follow-up (14%).</p></sec><sec><title>Conclusion</title><p>Rapid-deployment aortic valve system seems to be a viable option with acceptable morbidity and mortality in elderly high-risk patients with active infective endocarditis of the aortic valve.</p></sec>