Prótesis sin sutura Perceval S en la cirugía valvular aórtica de alto riesgo. Una herramienta fundamental para el cirujano

Abstract

ObjectiveSutureless aortic valve replacement has emerged as an innovative alternative for treatment of severe aortic stenosis. Patients and methodsBetween March 2012 and October 2016 Perceval S (Livanova, Saluggia, Italia) prosthesis was implanted in 262 patients (mean age: 77.97±6.12 years; 56.22% women). In 176 cases (67.18%) isolated aortic valve replacement was performed, 36.9% was minimally invasive approach. Clinical and echocardiographic follow-up was performed at discharge, 6 months and yearly after surgery. ResultsThe expected risk of mortality was 14.19±1.31% (Euroscore log I) and 7.47±1.11% (Euroscore log II). Observed hospital mortality was 4.23%. Neurological complications in 2 patients (0.94%), one transient, and moderate paravalvular leak 2 patients.Mean follow-up of 26±6.2 months. Follow-up mortality 1.9% (4 patients); leaks grade II in 2 patients. Mean transprosthetic gradient of 10.2mmHg; 95% of patients in functional class I-II. ConclusionsThe use of the sutureless Perceval S (Livanova, Saluggia, Italia) prosthesis for surgical treatment of severe aortic stenosis has shown to be feasible, safe and effective. This valve is a very useful tool in high risk aortic patients, with low mortality and low complications rates, and highly versatile has allowed us to solve very complex cases.