Background: Biological prostheses 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 hemodynamic performance and clinical outcome of the Inspiris bioprosthesis in patients aged 56 ± 10.7 years.
Methods and Results: Between may 2018 and December 2022, 342 patients aged 56 ± 10.7 years underwent AVR with the Edwards Inspiris bioprosthesis at our institution. 37 of them (10.8%) were younger than 40, and 98 (28.6%) had a BMI >30 kgm2. A minimally invasive approach was used in all isolated AVR patients. Associated procedures were performed in 157 (45.9%) patients. There were 56 redo patients (16.4%). 7 patients died (2%). Major complications included bleeding (32), respiratory failure (20) and BAV requiring PMK (4). The mean follow up was 23 ± 15.2 months (range 2-55). Late valve–related events included endocarditis (5) requiring reoperation. There were no thromboembolic events, valve thrombosis or SVD cases. At follow up, all except four patients reported a significant improvement of their symptomatic status (98.8% were in NYHA II) and quality of life.
Conclusion: Our study demonstrates excellent early haemodynamics and promising results at up to four years in a cohort of very young patients. Further studies with longer follow–up are needed