Sutureless bioprosthesis for aortic valve replacement: surgical and
clinical outcomes
Abstract
Aortic valve stenosis is the most common adult valve disease in
industrialized countries. The ageing population and the increase in
comorbidities urge the development of safer alternatives to the current
surgical treatment. Sutureless bioprosthesis have shown promising
results, especially in complex procedures and in patients requiring
concomitant surgeries. Objectives: Assess the clinical and
hemodynamic performance, safety, and durability of the Perceval
® prosthetic valve. Methods: This single
center retrospective longitudinal cohort study collected data of all
adult patients with aortic valve disease who underwent aortic valve
replacement with a Perceval ® prosthetic valve between
February 2015 and October 2020. Of the 196 patients included (mean age
77.20±5.08 years; 45.4% female; mean EuroSCORE II 2.91±2.20%), the
majority had aortic stenosis. Results: Overall mean cross-clamp
and cardiopulmonary bypass times were 33.31±14.09 and 45.55±19.04
minutes, respectively. Mean ICU and hospital stay were 3.32±3.24 and
7.70±5.82 days, respectively. Procedural success was 98,99%, as two
explants occurred. 4 valves were reimplanted due to intra-operative
misplacement. Mean transvalvular gradients were 7.82±3.62 mmHg.
Pacemaker implantation occurred in 12.8% of patients, new-onset atrial
fibrillation in 21.9% and renal replacement support was necessary in
3.1%. Early mortality was 2.0%. We report no structural valve
deterioration, strokes or endocarditis and one successfully treated
valve thrombosis. Conclusions: Our study confirms the excellent
clinical and hemodynamic performance and safety of a truly sutureless
aortic valve, up to 5-year follow-up. These results were consistent in
isolated and concomitant interventions, solidifying this device as a
viable option for treatment of isolated aortic valve disease.