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.