Interventional Technique:
As in conventional surgical aortic valve replacement (SAVR), we placed
patients on cardiopulmonary bypass, and the native leaflets were excised
during cardiac arrest. The INTUITY Elite valve is designed to be
compatible with conventional SAVR techniques with standard access to the
aorta. In the first 20 patients in this series, we did not perform
additional stitching, and PVL occurred in 4 patients. Therefore, in the
latter 18 patients, a new stitch was added whenever there was a gap in
the commissure.
We always performed debridement according to the traditional method of
conventional SAVR. We believe that debriding all calcium from the
annulus, left ventricular outflow tract (LVOT), anterior mitral valve
leaflet, and sinus of the Valsalva is indispensable to ensure proper
prosthetic valve positioning on the annulus and for optimal frame
expansion.
After excising the calcified aortic valve and decalcifying the annulus,
we must decide whether to use the INTUITY Elite valve because it is
necessary to assess the interaction of the prosthesis with the aortic
annulus. Failure to consider these factors can lead to implant failure
and complications, such as PVL.