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Novel and Innovative Hybrid Technique for Type A Aortic Dissection

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Concomitant Ascending Aortic Replacement and Aortic Valve Replacement Using Rapid Deployment Bioprosthesis.

Ricardo Ferreira¹, Nádia Junqueira¹, Ricardo Arruda¹

¹Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular

|November 18, 2019

Summary

Rapid deployment valves significantly reduce cross-clamping and bypass times for combined aortic valve and ascending aorta replacement. This initial experience suggests potential for improved clinical outcomes without increased risks.

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Area of Science:

Cardiovascular Surgery
Thoracic Surgery
Medical Devices

Background:

Aortic valve disease frequently coexists with ascending aorta dilatation, necessitating combined surgical repair.
Guidelines recommend surgery when ascending aorta diameter exceeds 45mm.
Rapid deployment valves offer reduced surgical times compared to traditional valves.

Purpose of the Study:

To evaluate the initial experience of using the Edward Intuity Elite™ rapid deployment valve for concomitant aortic valve and ascending aorta replacement.
To assess the safety and efficacy of this combined procedure.

Main Methods:

Retrospective analysis of male patients undergoing combined aortic valve and ascending aorta replacement with the Edward Intuity Elite™ valve.
Data collection included cross-clamping time, cardiopulmonary bypass time, and intensive care unit (ICU) stay.
Post-discharge follow-up at 1 and 3 months.

Main Results:

The study included only male patients with a mean age of 72 years.
Mean cross-clamping time was 48 minutes and mean cardiopulmonary bypass time was 61 minutes.
Mean ICU stay was 4 days, with all patients reported to be doing well at follow-up.

Conclusions:

Rapid deployment valves are advantageous for aortic valve replacement.
Combined aortic valve and ascending aorta replacement using the Edward Intuity Elite™ valve appears feasible and safe in this initial cohort.
Further large-scale studies are warranted to confirm these promising clinical outcomes.