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Article Dans Une Revue Journal of Cardiovascular and Thoracic Research Année : 2021

Rapid-deployment aortic valve replacement in high-risk patients: A case-control study

Adama Sawadogo
an Vinh Bui-Duc
  • Fonction : Auteur
Nicolas d'Ostrevy
  • Fonction : Auteur
  • PersonId : 1345629
  • IdHAL : ndostrevy
Lionel Camilleri
  • Fonction : Auteur
Kasra Azarnoush
  • Fonction : Auteur

Résumé

Introduction: Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. In high-risk patients, conventional aortic valve replacement (C-AVR) carries high rates of morbidity and mortality. In the last few years, rapid-deployment valves (RDV) have been developed to reduce the surgical risks. In this work, we aimed to compare the mid-term outcomes of rapid-deployment AVR (RD-AVR) with those of the C-AVR in high-risk patients. Methods: This retrospective case-control study identified 23 high-risk patients who underwent RD-AVR between 12/2015 to 01/2018. The study group was compared with a control group of 46 patients who were retrospectively selected from a database of 687 C-AVR patients from 2016 to 2017 which matched with the study group for age and Euro SCORE II. Results: RD-AVR group presented more cardiovascular risk factors. Euro SCORE II was higher in the RD-AVR group (P=0.06). In the RD-AVR group, we observed significantly higher mean prosthetic size (P<0.001). In-hospital mortality was zero in RD-AVR group versus 2 deaths in C-AVR group. Hospital stay was longer in the RD-AVR group with statistical significance (P=0.03). In the group AVR with associated cardiac procedures, while comparing subgroups RD-AVR versus C-AVR, early mean gradient was lower in the first cited (P=0.02). The overall mean follow-up was 10.9 ± 4.3 months. Conclusion: The RD-AVR technique is reliable and lead to positive outcomes. This procedure provides a much larger size with certainly better flow through the aortic root. It is an alternative to C-AVR in patients recognized to be surgically fragile.

Dates et versions

hal-03673530 , version 1 (20-05-2022)

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Citer

Adama Sawadogo, an Vinh Bui-Duc, Nicolas d'Ostrevy, Lionel Camilleri, Kasra Azarnoush. Rapid-deployment aortic valve replacement in high-risk patients: A case-control study. Journal of Cardiovascular and Thoracic Research, 2021, 13 (1), pp.23-27. ⟨10.34172/jcvtr.2021.10⟩. ⟨hal-03673530⟩
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