Aortic valve replacement and concomitant procedures with the Perceval valve: results of European trials.

Shrestha, Malakh; Folliguet, Thierry A; Pfeiffer, Steffen; Meuris, Bart; Carrel, Thierry; Bechtel, Matthias; Flameng, Willem J; Fischlein, Theodor; Laborde, François; Haverich, Axel (2014). Aortic valve replacement and concomitant procedures with the Perceval valve: results of European trials. The Annals of Thoracic Surgery, 98(4), pp. 1294-1300. Elsevier 10.1016/j.athoracsur.2014.05.033

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BACKGROUND The Perceval (Sorin Group, Milan, Italy) is a self-anchoring sutureless aortic valve prosthesis. We report the short- to midterm results of combined aortic valve replacement (AVR) with concomitant procedures in elderly patients undergoing operation as part of 3 consecutive prospective multicenter European studies. METHODS From April 2007 to February 2013, 243 patients (mean age, 79.7 ± 5.1 years; female patients, 61%; median EuroSCORE, 9%) underwent AVR with concomitant procedures. The concomitant procedures were coronary artery bypass grafting (CABG) (182 cases), septal myectomy (21 cases), CABG + other procedures (18 cases), and 22 other procedures. Primary and secondary end points included implant feasibility and safety (for mortality and morbidity) and efficacy (New York Heart Association [NYHA] class improvement and hemodynamic results) of the prosthesis at the different follow-up periods. Data were expressed as mean ± standard deviation. Kaplan-Meier analysis was performed for survival analysis. RESULTS Mean aortic cross-clamp and extracorporeal circulation (ECC) times were 50.7 ± 22.8 minutes and 78.9 ± 32.3 minutes, respectively. Thirty-day mortality was 2.1%. Mean postoperative gradient and effective orifice area were 10.1 ± 4.7 mm Hg and 1.5 ± 0.4 cm(2) and 8.9 ± 5.6 mm Hg and 1.6 ± 0.4 cm(2), respectively, at 1 year. There were early explantations, 4 of which resulted from paravalvular leaks. One additional valve explantation resulted from aortic root bleeding, probably caused by excessively extensive decalcification. In the late period, there was 1 mild paravalvular leak and no intravalvular insufficiency. No migration, dislodgement, or degeneration of the valve occurred during follow-up. Median follow-up was 444 days. CONCLUSIONS These trials confirm the safety and efficacy of the Perceval sutureless aortic valve, especially in elderly patients requiring AVR + concomitant procedures. In this patient group, sutureless valves may be advantageous compared to transcatheter valve implantations as concomitant procedures other than percutaneous coronary artery angioplasty are not always possible in the latter.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1552-6259

Publisher:

Elsevier

Language:

English

Submitter:

Sara Baumberger

Date Deposited:

09 Mar 2015 15:11

Last Modified:

27 Oct 2015 11:27

Publisher DOI:

10.1016/j.athoracsur.2014.05.033

PubMed ID:

25106682

BORIS DOI:

10.7892/boris.64165

URI:

https://boris.unibe.ch/id/eprint/64165

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