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Canadian Journal of Cardiology

RAPID DEPLOYMENT VALVES ARE ADVANTAGEOUS IN THE REDO SETTING: COHORT STUDY

      BACKGROUND

      The spectrum on how to manage aortic valve disease continues to widen. The role of rapid deployment valves (RDVs) remains unclear, with the current literature suggesting modest benefit from the reduced operative times. The purpose of this study is to add further clarification to their role by comparing the outcomes of RDVs with traditional sutured valves (TSVs) in the reoperative aortic valve replacement (AVR) setting.

      METHODS AND RESULTS

      This study was a retrospective review of all patients undergoing a second surgical reoperation for aortic valve disease. Patients were categorized into 2 groups: (1) RDV and (2) TSV. Cox proportional hazards regression models were used to determine the association between exposure of interests and the primary and secondary outcomes, after adjusting for all the baseline characteristics. The primary outcome was major adverse cardiovascular event (MACE) at 3 years, which was the composite of all-cause death, readmission for myocardial infarct, readmission for stroke, and readmission for heart failure. A total of 307 patients made up the study population from 2010-2019. Of those, 254 patients received a TSV and 53 patients received a RDV. RDV patients were significantly older than TSV patients by 10 years on average. Shorter cardiopulmonary bypass (CPB) times were found with the RDV group. There was no significant difference in the primary outcome of MACE at 3 years, but there was a trend towards lower mortality in the RDV group, with 0 deaths at 3 years.

      CONCLUSION

      In conclusion, this single-centre large cohort study of reoperative AVR patients found that RDVs are beneficial by saving an hour on CPB and showing a trend towards lower mortality.
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