Sutureless Perceval versus Bioprosthetic Aortic Valve, Single Center Experience

Mohamed Abdel Hafez Fouly

doi:10.35810/ects.v2i2.126

Mohamed Abdel Hafez Fouly Cardiothoracic Surgery Department, Faculty of Medicine, Cairo University, Giza, Egypt

DOI: https://doi.org/10.35810/ects.v2i2.126

Keywords: Sutureless aortic valve, Aortic bioprosthesis, Calcific aortic stenosis

Abstract

Background: High-risk patients are currently presenting for aortic valve replacement (AVR). Sutureless valves may decrease the operative risk in those patients. The objective of this study was to compare the short-term and one-year follow-up results of the sutureless Perceval valve versus bioprosthetic aortic valve.

Methods: The data of patients who underwent elective AVR with bioprosthesis were collected From March 2012 to March 2017. The patients were divided into two groups; group 1 included the patients who had a sutureless aortic valve (Perceval) (n= 25; 3.57% of total AVR patients), and group 2 included patients who had conventional bioprosthesis (n= 50; 7.1% of total AVR patients).

Results: The median age of patients in group 1 was 67 years (25^th- 75^th percentiles; 64-71), and in group 2 was 66 years (25^th- 75^th percentiles: 63 to 69). There is no significant difference in the patients’ comorbidities between the two groups. The median duration of the ischemic time was significantly lower in group 1 (33 (25^th- 75^th percentiles: 32- 35) vs. 60.5 (58- 66), respectively; p< 0.001). Perceval valve was used more commonly in patients who had minimally invasive AVR (n= 21 (84%) in group 1 vs. 11 (22%) in group 2; p<0.001). Postoperative complications were comparable between both groups. The early paravalvular leak was non-significantly higher in group 1 (12% vs. 2%; p= 0105). The mean postoperative gradient was lower in group 1 (7 (7-9) vs. 10 (8-12) mmHg; p<0.001). The changes in valvular gradient were not significantly different between both groups (p= 0.5). The hospital stay was lower in patients received Perceval valve (Coefficient: -1.3; 95% Cl: -2.3- -0.29; p=0.012)

Conclusion: Sutureless aortic valve (Perceval) is a new surgical technique for AVR, with potential advantages of reducing cross-clamp time and a subsequent reduction in myocardial ischemia, duration of cardiopulmonary bypass, and maintaining satisfactory hemodynamic outcomes through reducing patient prosthesis mismatch. All these advantages could help in decreasing postoperative hospital stay.