Abstract
Background and Aim: Perceval sutureless aortic bioprosthesis (LivaNova, Italy) represents an innovative approach for surgical aortic valve replacement (AVR), in order to reduce operative time and facilitate prosthesis implantation, specially in complex procedures. We described our experience with Perceval bioprosthesis in cardiac reoperations (REDO). Methods: From March 2011 to December 2017, 841 patients underwent AVR with sutureless aortic Perceval bioprosthesis at our Institution. Of these, 72 patients had previously undergone cardiac surgery. Mean age was 73 ± 4 years, 33 patients were female (46%), and mean logistic EuroSCORE was 27.3 ± 14%. Preoperative, periprocedural and echocardiographic parameters, as well as clinical outcomes, were analyzed. Results: The primary procedure was aortic valve surgery in 46 patients (64%). Isolated REDO AVR was performed in 51 patients (71%). REDO surgery was performed via full sternotomy in 63 patients (87.5%) and via right minithoracotomy in 9 patients (12.5%). Cardiopulmonary bypass and aortic cross-clamp times were 98.4 ± 34.3 and 53.3 ± 35.7 minutes for isolated AVR and 176.4 ± 71.5 and 108.1 ± 39.7 minutes for combined procedures. In-hospital deaths occurred in 4 patients (5.5%), two patient had cardiac death, and all patients were alive at a mean follow-up of 28.6 ± 12.4 months. Pacemaker implantation was performed in 4 patients. On echocardiographic evaluation, no patient showed paraprosthetic leakages and mean transprosthesis gradient was 10.4 ± 6.3 mmHg. Conclusions: Perceval sutureless AVR is a fast and safe procedure, even in high-risk REDO surgery, providing a good hemodynamic performance with excellent clinical results.
Published Version
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