title: Rapid-deployment aortic valve replacement for severe aortic stenosis: 1-year outcomes in 150 patients.
abstract: This study aimed to evaluate the safety and effectiveness of rapid-deployment aortic valve replacement (RDAVR) for severe aortic stenosis (AS).
  
  
  
  All consecutive patients with severe AS who underwent RDAVR with the EDWARDS INTUITY bioprosthesis were prospectively included in a single-centre, cohort study between July 2012 and April 2015. Clinical examination and transthoracic echocardiography were performed preoperatively and at 1-month and 1-year follow-up.
  
  
  
  We included 150 patients: mean age 76.8 ± 6.2 years, 68.7% male and mean EuroSCORE II 3.4 ± 3.7%. Implantation was successful in all: 103 (68.7%) had isolated aortic valve replacement (AVR) and 47 (31.3%) had concomitant procedures. For isolated AVR, mean cross-clamp and cardiopulmonary bypass times were 37.6 ± 13.3 and 59.9 ± 20.4 min, respectively. Overall, the 1-year Kaplan-Meier survival rate was 97.1% (95% confidence interval 92.4-98.9%). At 1 year, stroke occurred in 5 patients (3.34%), myocardial infarction in 1 (0.69%), endocarditis in 1 (0.69%), early explantation in 1 (0.67%), pacemaker implantation in 8 (5.6%) and Grade 2 periprosthetic regurgitation in 4 (3.2%; no grade 3 of 4). There were significant decreases from baseline ( P  < 0.001) in the proportion at New York Heart Association Class III/V (35.3-4.1%), mean gradient (54.9 ± 17.3 mmHg to 11.3 ± 4.8 mmHg) and mean left ventricular mass index (160.3 ± 44.8 g/m 2 to 118.5 ± 39.4 g/m 2 ). Mean indexed effective orifice area at 1 year was 1.02 ± 0.37 cm 2 /m 2 . Ten patients (6.6%) had severe patient-prosthesis mismatch.
  
  
  
  RDAVR for severe AS provided favourable outcomes over 1 year.
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Theron
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Eleonore
authors.initials: E
authors.lastname: Ravis
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Grisoli
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jaussaud
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Morera
authors.affiliation: Department of Biostatistics, Edwards Lifesciences, Nyon, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Candolfi
authors.affiliation: Department of Biostatistics, Edwards Lifesciences, Nyon, Switzerland.
authors.forename: Jana
authors.initials: J
authors.lastname: Boleckova
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: David
authors.initials: D
authors.lastname: Lagier
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Amanatiou
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Lyna
authors.initials: L
authors.lastname: Messous
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Vlad
authors.initials: V
authors.lastname: Gariboldi
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Marseille, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Collart
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001705:Bioprosthesis; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D010496:Pericardium / Q000637:transplantation; D011446:Prospective Studies; D011474:Prosthesis Design; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Aortic stenosis; Aortic valve replacement; Bioprosthesis; Rapid deployment