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The Use of Sutureless and Rapid-Deployment Aortic Valve Prosthesis in Patients with Bicuspid Aortic Valve: A Focused Review
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  • Morgan King,
  • Thomas Stambulic,
  • Darrin Payne,
  • Angel Luis Fernandez,
  • Mohammad El-Diasty
Morgan King
Queen's University

Corresponding Author:[email protected]

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Thomas Stambulic
Queen's University
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Darrin Payne
Queen's University
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Angel Luis Fernandez
Universidade de Santiago de Compostela Facultade de Enfermaria
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Mohammad El-Diasty
Queen's University
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Abstract

The use of sutureless and rapid-deployment prostheses is generally avoided in patients with BAV due to anatomical concerns and the elevated risk of para-prosthetic leaks. Multiple studies have reported the use of these prostheses in patients with BAV with varying degrees of success. The focus of this review is to consolidate the available evidence on this topic. A scoping review was conducted using a comprehensive search strategy within Medline, Embase, and Cochrane Central Register of Controlled Clinical Trials for relevant articles. All abstracts and full texts were screened by two independent reviewers according to predefined inclusion and exclusion criteria. Of 1052 total citations, 44 underwent full text review and 13 (4 case reports, 6 retrospective analyses, and 3 prospective analyses) were included in the scoping review. Across all 13 studies, a total of 314 patients with BAV were used for data analysis. In sutureless and rapid-deployment prostheses, the mean postoperative aortic valvular gradients were less than 15mmHg in all studies with mean postoperative aortic valvular areas all greater than 1.3cm. There were 186 total complications for an overall rate of 59%. Individual complications included new onset atrial fibrillation (n=65), required pacemaker insertion (n=24), intraprosthetic aortic regurgitation (n=20), new onset atrioventricular block (n=18), and new onset paravalvular leakage (n=10). The use of sutureless and rapid deployment prostheses in patients with BAV showed comparable intraoperative and implantation success rates to patients without BAV. Various techniques have been described to minimize complications in patients with BAV receiving sutureless or rapid-deployment prostheses.
13 Feb 2022Submitted to Journal of Cardiac Surgery
14 Feb 2022Submission Checks Completed
14 Feb 2022Assigned to Editor
20 Feb 2022Reviewer(s) Assigned
10 Mar 2022Review(s) Completed, Editorial Evaluation Pending
13 Mar 2022Editorial Decision: Revise Major
02 Apr 20221st Revision Received
02 Apr 2022Submission Checks Completed
02 Apr 2022Assigned to Editor
02 Apr 2022Reviewer(s) Assigned
02 May 2022Review(s) Completed, Editorial Evaluation Pending
09 May 2022Editorial Decision: Revise Minor
01 Jun 20222nd Revision Received
02 Jun 2022Submission Checks Completed
02 Jun 2022Assigned to Editor
02 Jun 2022Reviewer(s) Assigned
17 Jun 2022Review(s) Completed, Editorial Evaluation Pending
02 Jul 2022Editorial Decision: Accept
Oct 2022Published in Journal of Cardiac Surgery volume 37 issue 10 on pages 3355-3362. 10.1111/jocs.16795