Challenge for Perceval: Aortic Valve Replacement With Small Sutureless Valves–A Multicenter Study

Villa, Emmanuel; Messina, Antonio; Laborde, F; Shrestha, Malakh; Troise, Giovanni; Zannis, Konstantinos; Haverich, Axel; Elfarra, Mazen; Folliguet, Thierry

doi:10.1016/j.athoracsur.2014.09.090

Cited by 31 publications

(29 citation statements)

References 20 publications

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“…There were no randomized controlled trials. The mean follow-up time was 6 to 8 months for 3 studies (15,18,19), 10 to 16 months for 5 studies (10,11,13,21,22), and 18 to 24 months for 3 studies (12,20,23), as seen in Table 1.…”

Section: Quality Of Evidencementioning

confidence: 97%

“…The pooled rate of pacemaker implantation 6.76% (95% CI, 4.68-8.86%) ( Figure 3B) and the pooled rate of cerebrovascular accidents was 1.73% (95% CI, 1.23-2.22%) ( Figure 3C). Table 3 provides a summary of additional perioperative outcomes including atrial fibrillation, pericardial tamponade, myocardial infarction, reoperation, explantation of the sutureless valve, exploration for bleeding, infection, length defined and reported in only one study (12). The pooled mean of moderate to severe paravalvular leak was 1.9% (95% CI, 0.97-3.7%).…”

Section: Assessment Of Safetymentioning

confidence: 99%

“…All studies originated from specialised tertiary referral centers. Eleven centers reported results in greater than 100 patients (range, 120-314) (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Seven studies presented multi-center data (12,13,(15)(16)(17)19,23).…”

Section: Quality Of Evidencementioning

confidence: 99%

“…All 14 studies were observational, which included 7 prospective (11,14,16,(19)(20)(21)(22) and 7 retrospective studies (10,12,13,15,17,18,23). There were no randomized controlled trials.…”

Section: Quality Of Evidencementioning

confidence: 99%

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Early results of the Sorin® Perceval S sutureless valve: systematic review and meta-analysis

Sian

Selvakumar

et al. 2017

J. Thorac. Dis.

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Background: Minimally invasive aortic valve replacement (MAVR) has demonstrated a benefit with respect to increased patient satisfaction due to minimised pain and earlier recovery. Sutureless valves may benefit MAVR and conventional aortic valve replacement (AVR) by reducing operative times and blood transfusion requirements. The Perceval valve (Sorin, Salluggia, Italy) is a self-expanding prosthesis made from bovine pericardium mounted in a nitinol stent, designed to simplify the implantation of an aortic valve. This metaanalysis evaluates the clinical, haemodynamic, and survival outcomes of the Perceval sutureless valve.Methods: An electronic search of 4 databases was performed from January 2000 to December 2016.Primary outcomes included mortality and stroke. Secondary outcomes included minimally invasive access, paravalvular leak, overall long-term survival, postoperative echocardiographic findings, and functional class improvement.Results: After the application of inclusion and exclusion criteria, 14 of 66 relevant articles were selected for assessment. Of these 14 studies, a total number of 2,505 patients were included. The current evidence on the Perceval valve for aortic valve disease is limited to observational studies only. Minimally invasive surgery was performed in 976 patients, of which 336 were via the right anterior thoracotomy approach. The Perceval M and L sutureless valves were the most frequently used, 782 and 770 respectively. The incidence of major adverse events included 30-day mortality (0 to 4.9%), cerebrovascular accident (0 to 3%), permanent pacemaker insertion (0 to 17%), moderate to severe paravalvular leak (0 to 8.6%), and re-operation (0 to 4.8%). Post-operative mean aortic valve gradient ranged from 9 to 15.9 mmHg and post-operative New York Heart Association (NYHA) Class I or II ranged from 82% to 96%. The 1-year survival ranged from 86% to 100%; and 5-year survival was 71.3% to 85.5% in two studies. Conclusions:The Perceval valve is associated with excellent post-operative results in MAVR and in conventional AVR. Larger randomised controlled studies are required to evaluate the long-term efficacy of the prosthesis.

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Section: Quality Of Evidencementioning

confidence: 97%

Section: Assessment Of Safetymentioning

confidence: 99%

Section: Quality Of Evidencementioning

confidence: 99%

“…All 14 studies were observational, which included 7 prospective (11,14,16,(19)(20)(21)(22) and 7 retrospective studies (10,12,13,15,17,18,23). There were no randomized controlled trials.…”

Section: Quality Of Evidencementioning

confidence: 99%

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Early results of the Sorin® Perceval S sutureless valve: systematic review and meta-analysis

Sian

Selvakumar

et al. 2017

J. Thorac. Dis.

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“…In high-risk patients, adding aortic root enlargement with prolongation of surgery may lead to detrimental effects. Hence, the use of RDV may prove to be a better strategy (75). Other groups that can benefit from RDV-AVR are the patients with severe aortic root calcification (76) or re-do AVR (77) where inserting stitches for conventional valves may prove to be very difficult or sometimes virtually impossible.…”

Section: Sutureless Mini-avr In High Risk Patientsmentioning

confidence: 99%

Minimally invasive aortic valve replacement in high risk patient groups

Fudulu

Lewis

Benedetto³

et al. 2017

J. Thorac. Dis.

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Minimally invasive aortic valve replacement (AVR) aims to preserve the sternal integrity and improve postoperative outcomes. In low risk patients, this technique can be achieved with comparable mortality to the conventional approach and there is evidence of possible reduction in intensive care and hospital length of stay, transfusion requirement, renal dysfunction, improved respiratory function and increased patient satisfaction. In this review, we aim to asses if these benefits can be transferred to the high risk patient groups. We therefore, discuss the available evidence for the following high risk groups: elderly patients, re-operative surgery, poor lung function, pulmonary hypertension, obesity, concomitant procedures and high risk score cohorts.

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Neue Technologien: Sutureless-Klappen

Bonaros

Stanger

2020

Kompendium Der Modernen Herzchirurgie Beim Erwachsenen

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Challenge for Perceval: Aortic Valve Replacement With Small Sutureless Valves–A Multicenter Study

Cited by 31 publications

References 20 publications

Early results of the Sorin® Perceval S sutureless valve: systematic review and meta-analysis

Early results of the Sorin® Perceval S sutureless valve: systematic review and meta-analysis

Minimally invasive aortic valve replacement in high risk patient groups

Neue Technologien: Sutureless-Klappen

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