OBJECTIVES : Advances in heart valve technology for surgical aortic valve replacement (SAVR) include rapid deployment valves which can reduce cross-clamp time, particularly important when complex concomitant procedures need to be performed. This study uses 'real world' data from the Premier Hospital database to compare patients undergoing conventional surgical aortic valves replacement (C-SAVR) to those treated with a rapid deployment aortic valve (RD-SAVR) with the objective to better understand hospital resource utilization and cost impact of rapid deployment valve usage.

METHODS : Eligible patients undergoing a primary SAVR procedure were captured in the Premier Hospital database between August 2016 and September 2017. Inpatient mortality, length of stay, operating room (OR) time and hospital costs were compared for patients having conventional SAVR versus rapid deployment using multivariable modeling. Each model adjusted for baseline demographics, comorbid conditions (as measured by the Elixhauser Comorbidity Index), hospital characteristics and whether the procedure was isolated SAVR versus concomitant SAVR.

RESULTS : A total of 10,811 patients underwent a SAVR procedure with conventional (10,333) or a rapid deployment (478) valve type with an average age of 67.3 and 69.6 years, respectively. Compared to C-SAVR, the rapid deployment cohort had a higher percentage of use in an academic hospital, 85% vs. 62%. Concomitant procedures occurred in 47% of conventional SAVR and 44% of rapid deployment patients. After multivariable modeling, patients undergoing conventional SAVR had 2.13 (P=.054) higher odds of mortality than rapid deployment. Least square means estimates for operating room time (423 vs 381 minutes; P<.0001) and length of stay (10.5 vs 9.7 days; P=0.0022) were significantly higher for conventional SAVR compared to rapid deployment. There were no statistical differences found in hospital costs between the two cohorts.

CONCLUSIONS : This initial 'real world' experience with rapid deployment valves, was associated with better outcomes and lower hospital utilization without significantly increasing hospital costs.