Abstract
ObjectiveThe aim of this retrospective study is to evaluate the safety and performance of the Perceval sutureless valve in patients undergoing aortic valve replacement. We report the 30-day clinical outcomes of 139 patients.MethodsFrom January 2014 to December 2016, 139 patients underwent sutureless aortic valve replacement. Their operation notes, National Adult Cardiac Surgery Database and perioperative transoesophageal echocardiography findings were studied retrospectively.ResultsNinety-two patients underwent isolated aortic valve replacement (group A) with Perceval valve and 47 patients had combined procedures of aortic valve replacement and coronary artery bypass grafting (group B). The patients received a size S (n=23), M (n=39), L (n=42) or XL (n=35) prosthesis. Perceval valve was successfully implanted in 135 (97.1%) patients. Mean cross-clamping time and bypass time were 40 and 63 minutes for isolated cases, while 68 and 107 minutes for combined cases. Three (2.1%) patients died within 30 days. Four patients suffered stroke and 5 patients went into acute renal failure. Median intensive care unit and hospital stay was 2 and 8.5, respectively. Four valves were explanted due to significant paravalvular leak after surgery. Five patients had permanent pacemaker as a result of complete heart block and mean postoperative drainage was 295 mL for isolated case and 457 mL for combined cases. The mean gradient across Perceval valve was 12.5 mmHg while its effective orifice area was 1.5 cm2.ConclusionEarly postoperative results showed that Perceval valve is safe. Further follow up is needed to evaluate the long-term outcome with this bioprosthesis.
Highlights
Severe aortic valve stenosis is a common cardiac disease among the elderly
Due to the increasing age of the patient population in the Western world, there has been an increase in the prevalence of patients with valvular heart disease eligible for aortic valve replacement (AVR)[1]
AVR is the treatment of choice for aortic valve stenosis when it is severe aortic stenosis (≤ 1 cm2/m2) and symptomatic, or asymptomatic with left ventricular dysfunction, or combined with other cardiac surgery procedure[2]
Summary
Severe aortic valve stenosis is a common cardiac disease among the elderly. Due to the increasing age of the patient population in the Western world, there has been an increase in the prevalence of patients with valvular heart disease eligible for aortic valve replacement (AVR)[1]. AVR is the treatment of choice for aortic valve stenosis when it is severe aortic stenosis (≤ 1 cm2/m2) and symptomatic, or asymptomatic with left ventricular dysfunction, or combined with other cardiac surgery procedure[2]. Given the increasing number of comorbidities and increasing patient age, a tendency has emerged to use biological valve implants, avoiding the need for long-term anticoagulation therapy. Transapical or transfemoral aortic valve implantations (TAVIs) have been introduced for high-risk patients ineligible for conventional AVR using cardiopulmonary bypass (CPB), it has its own limitations, e.g., significantly increased costs, inability to remove the calcified aortic valve, and the high.
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