Background: Rapid deployment (RD) aortic valve prostheses are known for ease of implantation,
as only a few sutures are needed to secure the device compared to a conventional prosthesis.
Their use in AVR/CABG procedures can shorten the duration of cardiac ischemia and
the overall intervention duration, which might have an impact on clinical results.
INCA is a prospective multicenter registry that aims to collect data from combined
AVR and CABG procedures using a rapid deployment aortic valve with a follow-up duration
of up to 5 years.
Methods: INCA is a prospective, multi-center registry enrolled 224 patients in 11 cardiac
institutions in Germany between 2017 and January 2020.
Clinical and echocardiographic intraoperative parameters, as well as at discharge,
30 days, 1 and 3-year follow-up data were collected.
Results: Mean age was 73.6 ± 6.1 years and mean logistic EuroSCORE was 7.8 ± 6.0%. The mean
number of distal arterial and venous anastomoses was 3.13 ± 1.56. Aortic X-clamp time
was 79.4 ± 24.1 min. at mean. At baseline, 11 patients (4.9.%) had already an implanted
pacemaker. Postoperatively, 17 patients (7.6%) required a new PPI, valve-related in
12 patients (5.4%). The 30-day mortality was 2.2% (5 patients) and the late mortality
up to 3 years was 11.2%. The patient's quality of life (SF-12 physical and mental
scores) was significantly restored and maintained for up to 3 years (p < 0.001). 5 patients (0.9%) underwent reoperation related to endocarditis. The majority
of implanted valves were size 25 mm. The postimplant mean gradient was 9.2 ± 3.7 and
after 3 years 8.9 ± 4.6 mmHg.
Conclusion: The use of a rapid-deployment aortic valve prosthesis in combination with a CABG
procedure is safe and time-effective. It offers stable and low transvalvular gradients
with satisfactory clinical outcomes.
The pacemaker rate appears to be slightly higher compared to conventional aortic valve
prostheses, with no significant clinical effect in the 3-year follow-up.
