Long‐term durability of a Perceval aortic valve implanted inside a calcified homograft root in a patient with Klippel–Trenaunay–Weber syndrome

Abstract

Background and Aims: Perceval valves are sutureless surgical bioprostheses designed for the aortic position. We report on the use of a Perceval sutureless valve for redo aortic valve replacement inside a heavily calcified homograft root in a patient with Klippel-Trenaunay-Weber syndrome. Materials and Methods: Anonymized patient case data was extracted from hospital electronic records. Results: A now 62-year-old woman with Klippel-Trenaunay-Weber syndrome underwent homograft aortic root replacement for congenital aortic valve dysplasia when she was 39 years old. She re-presented in 2012 with severe symptomatic aortic regurgitation through the homograft root. Computed tomography scanning revealed a heavily calcified homograft root. In order to avoid a high-risk redo root replacement or a challenging sutured aortic valve replacement, she underwent Perceval sutureless aortic valve implantation. As of 9.5 years following Perceval implantation, the bioprosthetic valve function remains excellent, with no transvalvular regurgitation seen. Discussion and Conclusion: This case reveals the value of Perceval valve implantation in redo surgery inside a hostile calcified homograft aortic root. Furthermore, we highlight the long-term durability of the Perceval sutureless bioprosthesis.

Rapid-Deployment Aortic Valve Replacement: Patient Selection and Special Considerations

“…In addition to these indications, SRDV may offer potential benefits in cases of complex reoperation, such as redo AVR in the setting of a hostile aortic root or failure of previous homograft as it facilitates valve implantation with less manipulation of friable tissues. [128][129][130] While SRDV may be a viable option for patients with BAV, careful consideration must be given to the indication. SRDV should be avoided if there is a complex calcification from the annulus to STJ, as this may increase the incidence of stroke from embolization, PVL, and PPI.…”