PERIOPERATIVE OUTCOMES WITH THE INTUITY VERSUS PERCEVAL VALVE SYSTEM: A PROPENSITY-MATCHED ANALYSIS OF 2 STRATEGIES IN INTERMEDIATE-RISK PATIENTS

Abstract

The recent emergence of new rapid-deployment valves could reduce the mean cross-clamping time and average bypass time in complex combined procedures and could facilitate minimally invasive access. This propensity-matched study compared clinical and echocardiographic outcomes between patients undergoing the rapid-deployment valve INTUITY implantation compared to sutureless valve PERCEVAL S replacement in the aortic position. Between 2011 and 2015, 45 patients underwent aortic valve replacement with prosthesis INTUITY at Montréal Heart Institute. The group was compared to 155 consecutive patients who had AVR with the PERCEVAL S in that same period. After propensity matching, 39 matched pairs were available for analysis. Mean age was 70 ± 7.6 years in the Intuity and 83 ± 2 years in the Perceval group (p=0.3). Pre-op Euroscore II predicted mortality score of matched groups were comparable (Intuity: 2.0% [1.5%, 3.9%] and Perceval 4.0% [2.2%, 7.7%] respectively (p=0.7). Median cardiopulmonary bypass time and cross-clamp time were lower in the Perceval group compared to the Intuity group (p<0.001). 30-day Mortality was 0% in the Intuity group and 7.7% in the Perceval group (p=0.24). There were more pacemaker implantations in the Perceval group 25.6% versus 12.8% in the Intuity group (p=0.23). The mean postoperative transprosthetic gradient was 12.5 ± 4.3 mmHg and postoperative effective orifice area was 2.0 ± 0.5 cm2 in the Intuity group compared to 15.5 ± 5.3 and 1.5 ± 0.5 cm2 in Perceval group. There were no significant differences in perioperative course and morbidities between matched groups. Shorter bypass time and cross-clamping time in Perceval group did not translate in significant decrease in early complications rates compared to the Intuity group. Mortality and morbidity are the same in both matched group. However, future studies allowing long-term durability and safety of sutureless valves are mandatory.