Sutureless Aortic Prosthesis Implantation: The First Brazilian Experience with Perceval Device

Abstract

previous thoracic surgery or chest radiation, comorbidities or overall frailty [2] .In this scenario, transcatheter aortic valve implantation (TAVI) has assumed an important role. It was initially designed for high risk patients, but now it can be used even in moderate risk ones [Society of Thoracic Surgeons (STS) score from 4% to 8%] [3] . Nevertheless, not all patients are candidates for TAVI, some due aortic root or valve abnormalities, others because additional cardiac procedures are needed (other valve replacement, coronary artery bypass grafting or repair of the aortic root).As alternatives to these difficulties, modern sutureless aortic prostheses have emerged. Since now, the Perceval prosthesis (LivaNova Biomedica Cardio Srl, Sallugia, Italy) has been considered the device that surgeons have more expertise. Its surgical implant allows complete and safe annulus decalcification and can be performed through minimally invasive procedures.A special subgroup of patients who could benefit from this device is that with a very small annulus, that could require aortic annular enlargement during aortic valve replacement or the elderly patients with comorbidities and calcified aorta.Considering that the Perceval sutureless aortic prosthesis is the most worldwide studied and implanted valve, this report

Екстериторијално Дејство Члана 3 Европске Конвенције За Заштиту Људских Права И Основних Слобода

“…Суд често као доказе о постојању злостављања у држави пријема користи извјештаје и акте одређених међународних организација и њихових органа, нпр. Amnesty International 44 , Human Rights Watch 45 , Међународни Комитет Црвеног Крста 46 , Специјални извјестилац о мучењу и осталим окрутним, нечовјечним или понижавајућим поступцима или кажњавањима 47 , Генерални секретар УН 48 , UNHCR 49 , Комитет УН против мучења 50 ; Љекари без граница 51 . Често наведене организације учествују у поступку пред Судом и као умјешачи.…”