RAPID DEPLOYMENT AND SUTURELESS AORTIC PROSTHESES. Time to validate
unusual or ‘off label’ indications?
Abstract
Currently available evidence supports the safety and efficacy of rapid
deployment and sutureless prostheses for aortic valve replacement (AVR)
in aortic stenosis as suggested by the International Expert Consensus in
2016. Following the increasing experience and the good results obtained
in AVR, the use of sutureless and rapid deployment prostheses in
peculiar situations, at times as an ‘off-label’ indication, has been
reported demonstrating to represent an effective solution to challenging
surgical problems, such as described by Piperata et al. in a recent
issue of the Journal of Cardiac Surgery for the treatment of active
infective endocarditis complicated by an extensive aortic annulus
abscess. The considerable experience acquired so far with rapid
deployment and sutureless valves has stimulated many surgeons to use
such devices in patients in whom limiting the overall ischemic time is
felt to be of paramount importance, but also in different surgical
scenarios. Therefore, we believe the time has come to strongly support
the unusual or even ‘off label’ employment of these devices by including
them in future recommendations.