Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatch?†

Abstract

The indexed effective orifice area of the sutureless group was significantly larger than in the sutured one. The incidence of PPM with the conventional sutured biprosthesis was 61.3%, while it decreases to 0% in the sutureless group. No PPM was reported in the sutureless valve group. Therefore, the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reduce the risk of a PPM.

Rapid deployment or sutureless versus conventional bioprosthetic aortic valve replacement: A meta-analysis

“…Therefore, a total of 21 studies were included in this review ( Figure E1). [4][5][6][7][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”

“…Among the 21 studies with 2785 patients (RDAVR group ¼ 1297 patients and CAVR group ¼ 1488 patients), 2 studies presented the results of RCTs (n ¼ 144), and 19 presented the outcomes of NRSs (n ¼ 2641). Twelve studies exclusively used the Perceval S (Sorin Group; Milan; Italy), 4,5,13,[15][16][17][21][22][23]25,27,28 whereas the Edwards Intuity valve (Edwards Lifescience Corp; Irvine, Calif) was used exclusively in 5 studies. 6,7,19,20,26 A minimally invasive approach through mini-sternotomies or right anterior thoracotomies were more frequently performed in the RDAVR group than in the CAVR group (69.1% vs 37.7%).…”

“…The ROB of both studies was considered low for the other domains. Of the 19 NRSs, 11 studies 4,6,7,13,15,18,[24][25][26][27][28] were graded as overall severe ROB because of the presence of confounding biases, because the patients' baseline characteristics were not balanced across groups and appropriate adjustments for confounding factors were not used. The other 8 studies used propensity score matching 14,16,17,20,21,23,29 or 1:1 matching 5 and were rated overall moderate ROB, because the baseline characteristics were similar between groups, and the other ROB items were graded low (Table E1).…”

“…The risks of acute renal failure, atrial fibrillation, bleeding reoperation, prolonged ventilation, and stroke were reported in 11, 7,13,17-21,23,25,28,29 9, 5,7,14,16,20,23,26,29 16, 4,6,7,14-21,23,25-27,29 6, 14,17,19,23,28,30 and 16 5,7,[13][14][15][16][17][18][19][20][21]23,[25][26][27][28] studies, respectively. The pooled analyses showed no significant differences in the risks of postoperative complications between the 2 groups ( Figure E2).…”

Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography

“…Assessment of prosthetic valve function is usually performed at rest after AVR. However, increasing gradients under high workload conditions are not an uncommon finding, particularly in case of narrow aortic annuli, unless aortic annular enlargement is performed . Accordingly, exercise echocardiography or DSE may unveil a prosthetic valve dysfunction otherwise overlooked at rest.…”