Thorac Cardiovasc Surg 2024; 72(S 01): S1-S68
DOI: 10.1055/s-0044-1780595
Sunday, 18 February
Alles rund um Herzklappenchirurgie

Combination of Surgical Coronary Revascularization and Implantation of a Rapid-Deployment Aortic Valve Prosthesis: 3-Year Follow-Up of the INCA German Registry

A. Lenos
1   RHÖN-KLINIKUM Campus Bad Neustadt, Bad Neustadt an der Saale, Deutschland
,
J. Strauch
2   Ruhr-University of Bochum, Bochum, Deutschland
,
M. Schlömicher
2   Ruhr-University of Bochum, Bochum, Deutschland
,
F. Fleißner
3   Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
,
D.M. Valencia-Nunez
4   Klinikum Links der Weser - Herzzentrum Bremen, Bremen, Deutschland
,
R. Gottardi
5   Klinik für Herz- und Gefäßchirurgie - Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg im Breisgau, Deutschland
,
P. Massoudy
6   Klinikum Passau, Passau, Deutschland
,
J. Gummert
7   Herz- und Diabeteszentrum NRW -Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Deutschland
,
G. Wimmer-Greinecker
8   Klinik für Herz- Thoraxchirurgie, Bad Bevensen, Deutschland
,
T. Walther
9   University Hospital Frankfurt, Frankfurt am Main, Deutschland
,
A. Diegeler
1   RHÖN-KLINIKUM Campus Bad Neustadt, Bad Neustadt an der Saale, Deutschland
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    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.


     

    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    13 February 2024

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