INTRODUCTION
Degenerative calcific valve aortic stenosis (AS) caused by
atherosclerosis is an active process of calcification and ossification
and is the most common form of AS.1 Calcified AS
prevalence is age-dependent, and aortic stenosis prevalence is
reportedly 3% in people above the age of 75 years.2Severe AS reportedly has a poor prognosis if untreated, even in the
absence of symptoms. Although many doctors are aware of this fact, they
are unable to persuade patients to undergo surgery because many patients
often refuse it owing to the fear of surgical risks . Due to the
widespread use of transcatheter aortic valve replacement (TAVR), cardiac
surgeons are accumulating clinical data to prove the long-term prognosis
and superior remote durability of aortic valve surgery.
Our fundamental goal was to prove the minimal invasiveness of aortic
valve surgery by applying rapid deployment aortic valve replacement
(RD-AVR) to new technologies and small incision approaches. The INTUITY
Elite valve (Edwards Life Sciences, Irvine, CA, USA) is designed for
rapid, easy, reproducible, and safe transplantation, with reduced
operative time and surgical complications.3–5However, studies reporting this prosthetic valve have vague cases and
recommendations.6,7The complications of this prosthetic valve include prosthetic valve
regurgitation and arrhythmias, for example, in the complete
atrioventricular block or left bundle branch block. We rarely have
patients who experience hemolytic anemias and heart failure due to
prosthetic valve regurgitation. In particular, paravalvular
regurgitation (PVL) is a rare complication with a frequency of
approximately 2.7%-17.8% (Figure 1); furthermore,
we have found that perivalvular
regurgitation can be predicted by electrocardiography-gated 3D-CT and
can be resolved by a simple procedure. We present an implantation
technique for aortic valve replacement along with collected data on
optimal annular size and shape. Furthermore, we report our one-year
single-center experience of 38 RD-AVR cases along with data on
postoperative outcomes, valve-related paravalvular leakage, and
hemodynamic performance.