Aortic Root Enlargement or Sutureless Valve Implantation?

Nikolaos G Baikoussis,Michalis Argiriou,Panagiotis Dedeilias

doi:10.3889/oamjms.2016.120

Nikolaos G Baikoussis, Michalis Argiriou + Show 1 more

Open Access

https://doi.org/10.3889/oamjms.2016.120

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Abstract

Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM) post aortic valve replacement (AVR) is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR) and the transcatheter valve implantation (TAVI).

Highlights

We read with great interest the case report written by doctor Selman Dumani et al and we would like to congratulate them for their successful fourth redo procedure and for their publication in this valuable journal [1]
The sutureless valves, like Perceval S aortic valve, are bioprosthetic valves indicated in old patients with comorbidities and small aortic root
We have used the Perceval S valve in some ’’difficult’’ cases like in patient with achondroplastic Dwarf [5] and in porcelain aorta with great results. Taken all these information about small aortic root, we would like to ask the authors about the use of a Perceval aortic valve in their patient

Summary

Introduction

We read with great interest the case report written by doctor Selman Dumani et al and we would like to congratulate them for their successful fourth redo procedure and for their publication in this valuable journal [1]. It is well known that in order to avoid the patient-prosthesis mishmash (PPM) there are some techniques like Manugian [2] and other surgical procedures. As referred in the international bibliography [3], stentless valve is another option.

Results

Conclusion