Rapid deployment versus its conventional counterpart in aortic valve replacement: comparison of early hemodynamic outcomes

Abstract

Background: Edwards Intuity is designed for rapid deployment based on the structure of Magna Ease. This study was conducted to compare early hemodynamic performance between the two valves. Methods: Patients who underwent aortic valve replacement (AVR) using Edwards Intuity or CarpentierEdwards PERIMOUNT Magna Ease in our institution from June 2016 to July 2021 were enrolled. Intuity valve was used in 215 patients, and Magna Ease valve was used in 198 patients, respectively. Early postoperative echocardiographic data were available in 99.0% (409/413) of the patients. The transvalvular mean pressure gradient, effective orifice area, and effective orifice area index were compared between the valves stratified by prosthesis size. Results: There were no differences in the proportion of female patients or body surface area between the groups. Mean pressure gradient on early postoperative echocardiography was significantly lower in Intuity valve than Magna Ease valve for 19, 21, 23, and 25 mm valves (15.5 & PLUSMN;5.0 vs. 20.8 & PLUSMN;9.1 mmHg, P=0.004; 12.7 & PLUSMN;4.2 vs. 15.6 & PLUSMN;5.3 mmHg, P=0.001; 11.5 & PLUSMN;3.3 vs. 13.4 & PLUSMN;5.8 mmHg, P=0.034; and 9.9 & PLUSMN;3.1 vs. 12.3 & PLUSMN;4.0 mmHg, P=0.029; respectively). Effective orifice area was larger in Intuity valve than Magna Ease valve for 19 mm valve (1.45 & PLUSMN;0.38 vs. 1.19 & PLUSMN;0.28 cm2, P=0.002), and effective orifice area index was also larger in Intuity valve than Magna Ease valve for 19 mm valve (0.96 & PLUSMN;0.26 vs. 0.80 & PLUSMN;0.20 cm2/m2, P=0.005). Early clinical outcomes, including operative mortality and postoperative complications, demonstrated no significant differences between the groups. Conclusions: Edwards Intuity demonstrated superior early hemodynamic performance compared with Magna Ease in a size-by-size comparison, and this superiority was more definite for small prostheses.