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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Long-term prognosis in patients undergoing redo-isolated aortic valve replacement
Aleksander Dokollari1,2, Gianluca Torregrossa3, Serge Sicouri3
1Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Centre, Maastricht, Netherlands.
Insights
Redo aortic valve replacement (AVR) outcomes were compared between sutureless, sutured, and valve-in-valve transcatheter AVR (ViV-TAVR) techniques. Sutureless AVR showed a higher incidence of new postoperative atrial fibrillation compared to sutured AVR.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Redo aortic valve replacement (AVR) is complex, with various techniques available.
- Comparing clinical outcomes of different redo AVR methods is crucial for patient management.
Purpose of the Study:
- To evaluate and compare clinical outcomes after redo AVR using sutured valves, valve-in-valve transcatheter AVR (ViV-TAVR), and sutureless valves.
- To assess the incidence of postoperative atrial fibrillation (POAF) among these redo AVR strategies.
Main Methods:
- A cohort of 113 consecutive patients undergoing redo AVR between August 2010 and March 2020 was analyzed.
- Patients were treated with either ViV-TAVR, redo-sutured AVR, or redo-sutureless AVR, with treatment decisions made by a heart team.
- Propensity-adjusted analysis was used to compare postoperative outcomes.
Main Results:
- Postoperative analysis revealed a higher incidence of new POAF in the redo surgical aortic valve replacement group compared to the redo-sutureless group (p=0.04).
- Follow-up outcome analysis did not reveal significant differences among the groups regarding other clinical outcomes.
Conclusions:
- Patients undergoing redo-sutureless AVR experienced a higher incidence of POAF compared to those undergoing redo-sutured AVR.
- The study highlights potential differences in early postoperative complications between redo AVR techniques.
Abstract:
Aim: To evaluate clinical outcomes after redo aortic valve replacement (AVR) with sutured valves, versus valve-in-valve transcatheter aortic valve replacement (ViV-TAVR), versus sutureless valves. Methods: We identified 113 consecutive patients undergoing redo AVR with either ViV-TAVR, redo-sutured and redo-sutureless valves between August 2010 to March 2020. Heart-team made the decision whether patient should undergo redo-sutureless versus ViV-TAVR, versus redo-sutured AVR. Results: Preoperatively, redo-sutured (n = 57), ViV-TAVR (n = 31) and redo-sutureless (n = 25) patients were compared. Postoperatively, after propensity-adjustment analysis, the redo surgical aortic valve replacement group had a higher incidence of new postoperative atrial fibrillation (POAF; p = 0.04) compared with redo-sutureless group. Follow-up outcomes analysis did not show differences among groups. Conclusion: Patients undergoing redo-sutureless AVR experienced a higher incidence of POAF compared with patients undergoing redo-sutured.
