Abstract 21365: Aortic Valve Replacement With Sutureless Perceval Valves: Step Towards Broader Application Of Minimally Invasive Surgery?
Objective: Even though minimally invasive surgery may be especially suitable for elderly patients with co-morbidities, this mode of intervention still has not seen broad application compared to the Mitral Valve Surgery. The purpose of this study was to assess suture-less aortic valve (Perceval Sorin) implantation via a mini-sternotomy.
Methods: As part of European Multicenter prospective, non-randomized, clinical trial, 55 Perceval valves were implanted in our center since 12/2007. Of these, twenty-five patients (20 females, age: 80±4 years) were operated via a mini-sternotomy. All patients had significant, symptomatic aortic valve stenosis (median gradient of 48±23 mm Hg). Twenty-three patients were in NYHA class III and the rest in class IV. The mean Euroscrore and STS scrore were 13±9% and 4±2 respectively.
Results: There were no failures of deployment or intra-procedural death.There was no 30 day mortality. Median Extra-corporeal circulation (ECC)-time was 71±25 min, X-Clamp 35±10 min. The valve implantation time was 9±3 mins. Peri-operative echocardiography revealed neither aortic insufficiency nor paravalvular leakage except minimal leakage in two patients. Mean length of hospital stay was 9 days. There was one re-thoracotomy due to bleeding. The post-operative mean gradient was 15±5 mm Hg. In follow-up, there was no paravalvular leakage or significant valvular insufficiency. The clinical status and left ventricular ejection fraction improved significantly as compared to pre-operatively. No migration or dislodgement of the prosthesis occurred.
Conclusions: This trial highlights the advantages of the Perceval S sutureless valve. It is a technically simple and more reproducible alternative for minimal invasive AVR. As the valve doesn't need to be sutured, the limited exposure is not a disadvantage even in patients with calcified or small aortic roots. All patients have returned to normal life.The lack of necessity for the valve prosthesis to be sutured, potentially reduces the X-clamp time and CPB time. This valve may enable broader application of minimal invasive AVR.
- © 2010 by American Heart Association, Inc.