Sutureless aortic valves in isolated and combined procedures: Thirteen years of experience in 784 patients

Lamberigts, Marie; Szecel, Delphine; Rega, Filip; Verbrugghe, Peter; Dubois, Christophe; Meuris, Bart

doi:10.1016/j.jtcvs.2022.09.053

Cited by 15 publications

(34 citation statements)

References 25 publications

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“…These earlier findings have been overturned by multiple larger trials, including multicenter studies which highlighted a correlation between the surgeon’s SU-AVR implantation learning curve and the pacemaker implantation rate [ 22 , 24 , 25 , 28 ]. Indeed, a significant reduction in pacemaker implantation rates has been reported by high-volume centers [ 22 , 24 , 28 , 29 ]. Due to the anatomical relations between the position of the conductive tissue and both valve prostheses, combined aortic and mitral valve replacement inherently carries a higher risk of permanent pacemaker implantation when compared to isolated aortic valve replacement.…”

Section: Discussionmentioning

confidence: 99%

Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement

Szczechowicz

Rad

Amanov

et al. 2023

Life

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Background: Sutureless aortic valve prostheses have proven to provide a significant decrease in procedural, cardiopulmonary bypass and cross-clamp time, leading to a significant reduction in mortality risk in elderly high-risk cohorts. In this study, we sought to review our institutional experience on the sutureless aortic valve replacement (SU-AVR) and the concomitant mitral valve replacement (SMVR), comparing the combined conventional surgical aortic valve replacement (SAVR) with SMVR. Methods and Material: Between March 2018 and July 2022, 114 consecutive patients underwent a combined aortic and mitral valve replacement at our institution. We stratified the patients according to the operative procedures into two groups and matched them 1:2: Group 1 underwent a combined conventional SAVR and SMVR (n = 46), and Group 2 included combined SU-AVR with Perceval prosthesis and SMVR (n = 23). Results: No significant differences in the preoperative characteristics were present. SU-AVR combined with SMVR demonstrated excellent haemodynamic performance, comparable to that of SAVR plus SMVR, with median postoperative gradients over the aortic valve of 4 mmHg (IQR 3.0–4.0) in Group 1 and 4 mmHg (IQR 3.0–4.0) in Group 2 (p = 0.67). There was no significant difference in the occurrence of postoperative major adverse events such as death, stroke, myocardial infarction and kidney failure between the groups. There was also no significant difference in the permanent pacemaker implantation rate, paravalvular leakage or valve dislocation. We also could not detect any significant difference in postoperative mortality between the groups. Conclusions: SU-AVR has proven to be a reliable alternative to conventional valve prostheses in patients with multivalve disease undergoing combined aortic and mitral valve replacement, offering shorter procedural time and outstanding hemodynamic performance compared to the conventional surgical method.

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Section: Discussionmentioning

confidence: 99%

Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement

Szczechowicz

Rad

Amanov

et al. 2023

Life

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“…They analysed 784 patients operated on between 2007 and 2019, and observed favourable early outcomes and low rates of early mortality, stroke and other major complications. Valve durability is promising with low rates of valve degeneration and a limited need for reintervention 15 …”

Section: Discussionmentioning

confidence: 99%

Ten-year experience with sutureless Perceval bioprosthesis: single-centre analysis in 1157 implants

Concistrè

Bianchi

Margaryan

et al. 2023

Journal of Cardiovascular Medicine

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Aims We describe long-term clinical and echocardiographic outcomes in the largest single-centre cohort of patients who underwent aortic valve replacement (AVR) with sutureless Perceval (CorCym, Italy) bioprosthesis. Methods Between March 2011 and March 2021, 1157 patients underwent AVR with Perceval bioprosthesis implantation. Mean age was 77 ± 6 years (range: 46–89 years) and mean EuroSCORE II was 6.7 ± 3.2% (range: 1.7–14.2%). Concomitant procedures were performed in 266 patients (23%). Results Thirty-day mortality was 1.38% (16/1157). Eight hundred and twenty of 891 (92%) isolated AVRs underwent minimally invasive surgery with a ministernotomy (n = 196) or right minithoracotomy (n = 624) approach. Cardiopulmonary bypass and aortic cross-clamp times were 81.1 ± 24.3 and 50.6 ± 11.7 min for isolated AVR and 144.5 ± 34.7 and 96.4 ± 21.6 min for combined procedures. At mean follow-up of 53.08 ± 6.7 months (range: 1–120.5 months), survival was 96.5% and mean transvalvular pressure gradient was 13.7 ± 5.8 mmHg. Left ventricular mass decreased from 152.8 to 116.1 g/m2 (P < 0.001) and moderate paravalvular leakage occurred in three patients without haemolysis not requiring any treatment. Freedom from reoperation was 97.6%. Eight patients required surgical reintervention and 19 patients transcatheter valve-in-valve procedure for structural prosthesis degeneration at a mean of 5.6 years after first operation (range: 2–9 years). Conclusion AVR with a Perceval bioprosthesis is associated with good clinical results and excellent haemodynamic performance in our 10-year experience. Structural degeneration rate of Perceval is comparable with other bioprosthetic aortic valves. Sutureless technology may reduce operative time especially in combined procedures and enable minimally invasive AVR.

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“…Perceval sutureless AVRs have been effectively used in the treatment of aortic stenosis. [23][24][25][26] The use of Perceval sutureless AVR for aortic valve insufficiency does have inherent concerns for possible issues with valve migration, related to the absence of a calcified aortic annulus. 29 The prosthetic valve has been used successfully with modifications to the implant technique and careful assessment of the aortic root anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…Longitudinal data available for the Perceval sutureless AVR would suggest excellent long-term clinical outcomes. 26 Nevertheless, as with all bioprosthetic valves, reintervention may be required should patient survival exceed bioprosthesis freedom from structural valve deterioration. Unlike preconstructed bioconduits, the sutureless BioBentall would be the first to allow simplified deconstruction of the Bentall conduit facilitating rapid removal and replacement of the prosthetic valve.…”

Section: Surgical Techniquementioning

confidence: 99%

The Sutureless Biological Bentall Procedure: A New Technique to Create a Modular Valve-Conduit Construct

Gallegos

Geršak

2023

Innovations�(Phila)

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The Perceval sutureless valve (Corcym, Saluggia, Italy) has been effectively adopted by surgeons for the treatment of degenerative aortic valve stenosis. Its simplified true sutureless implantation technique has proven useful for minimally invasive cases, but the use of Perceval as part of more complex root replacement has not previously been described. We present a novel technical modification to the manufactured biologic Bentall, called the sutureless biological Bentall. This technique allows for a true modular valve–conduit construction that will simplify future reintervention.

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Sutureless aortic valves in isolated and combined procedures: Thirteen years of experience in 784 patients

Cited by 15 publications

References 25 publications

Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement

Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement

Ten-year experience with sutureless Perceval bioprosthesis: single-centre analysis in 1157 implants

The Sutureless Biological Bentall Procedure: A New Technique to Create a Modular Valve-Conduit Construct

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