Predicting the ideal Valve Size during Aortic Valve Replacement with
Rapid Deployment Bioprosthetic Valves. Is Intraoperative Transesophageal
Sutureless/rapid deployment valves provide surgeons with a new tool for
aortic valve replacement (AVR) therapy, which can simplify the
procedure. A main concern being the development of a paravalvular leak.
We retrospectively reviewed our Aortic Valve Replacement database, were
able to identify 25 rapid deployment aortic valves (INTUITY Valve
System, Edwards Life Sciences LLC, Irvine, Calif) that had documented
intraoperative Transesophageal Echocardiographic Annular measurements.
All valves were implanted in the Aortic position. In this cohort, only
patients that had their native aortic valve replaced either isolated or
as part of any additional procedure were included. Patients that
underwent Intuity valve implantation for Redo Aortic valve replacement
were excluded from this study. After review of 25 patients who underwent
rapid deployment valve implantation in the aortic position, 36% of
patients had the same size valve as the measured aortic annulus, 48% of
patients had a valve implanted that was 1 mm different, and 16% of
patients had 2 mm difference. The mean annular size based on
intraoperative TEE was 22.4 mm (range: 21-28 mm). The mean valve size
that we implanted was 23.3 mm (range: 21-27 mm). No statistically
significant difference between the mean annular measurement and the
valve size selected (0.9 mm , p = 0.8) were found. TEE is perhaps
remains as one of our most important tool to further enhance valve
sizing and appropriately guide one through a proper and safe deployment.