OBJECTIVES: The supra-annular aortic valve replacement (SA-AVR) allows
for implantation of larger prostheses. We describe the technique, early
post-operative outcomes and hospital mortality. METHODS: Patients who
underwent SA-AVR with the Carpentier-Edwards Magna Ease bioprosthesis
between December 2010 and December 2017 were retrospectively reviewed.
The prosthesis was sutured to the aortic annulus along the coronary
sinuses, and in a supra-annular position along the non-coronary sinus.
RESULTS: 115 patients were included (mean age: 71,6 years ± 9,4). Mean
bioprosthesis diameter was 23,3 ± 1,7 mm. Four early deaths were
observed in the ICU. Early post-operative complications included:
re-operation for bleeding (n=6), tamponade (n=7), permanent
atrioventricular block (n=4) and hemodialysis (n=2). In-hospital
mortality was 3,48%. Postoperative echocardiography showed a marked
decrease in the mean left ventricle – aorta gradient (50,4 ± 16,1 mmHg
vs 11,3 ± 4,05 mmHg). CONCLUSION: SA-AVR is safe and associated with
favourable immediate outcomes in patients with small aortic annulus.