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.