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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© 2021 Published by Elsevier Inc.
