Intermediate-term results of a new aortic bioprosthesis in patients at increased risk of early svd

Abstract Background and aim Biological prosthesis are increasingly been used in young patients to avoid anticoagulation. The Edwards Inspiris aortic bioprosthesis is extremely promising in this population, since it has shown reduced calcification of the prosthetic leaflets in preclinical and early clinical studies. Little data are available, however, in patients younger than 65. This study investigates the haemodynamic performance and clinical outcome of the Inspiris bioprosthesis in patients aged < 50 years. Methods Between May 2018 and May 2022, 58 patients aged 41±7.8 years underwent AVR with the Edwards Inspiris bioprosthesis. Twenty–three (39.65%) were younger than 40, and 7 (12.06%) had a BMI >30 kgm2. A minimally invasive approach was used in all isolated AVR patients. Associated procedures were performed in 25 (43.10%) patients. There were 10 redo patients (17.2%). Results Major complications included bleeding (4), respiratory failure (1) and BAV requiring PMK (1). Two patients died (3.45%). The mean follow up was 29.6±12.3 months (range 10–51). Late valve–related events included endocarditis (2) requiring reoperation. There were no thromboembolic events, valve thrombosis or SVD cases. At follow up, all except one patient reported a significant improvement of their symptomatic status (96.29% were in NYHA II) and quality of life. The mean interval to return to the normal activity was of 5.37±3.3 months. Conclusion Our study demonstrates promising results at up to 4 years in a cohort of very young patients. Further studies with longer follow–up are needed.