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Sutureless bioprosthesis for aortic valve replacement: surgical and clinical outcomes
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  • Ricardo Ferreira,
  • Nuno Rua,
  • André Sena,
  • Tiago Velho,
  • João Goncalves,
  • Nádia Junqueira,
  • Ana G. Almeida,
  • Angelo Nobre,
  • Fausto Pinto
Ricardo Ferreira
Centro Hospitalar Universitario Lisboa Norte EPE
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Nuno Rua
Universidade da Beira Interior Faculdade de Ciencias da Saude
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André Sena
Centro Hospitalar Universitario Lisboa Norte EPE
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Tiago Velho
Centro Hospitalar Universitario Lisboa Norte EPE
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João Goncalves
Centro Hospitalar Universitario Lisboa Norte EPE
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Nádia Junqueira
Centro Hospitalar Universitario Lisboa Norte EPE
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Ana G. Almeida
Centro Hospitalar Universitario Lisboa Norte EPE
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Angelo Nobre
Centro Hospitalar Universitario Lisboa Norte EPE
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Fausto Pinto
Centro Hospitalar Universitario Lisboa Norte EPE
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Abstract

Aortic valve stenosis is the most common adult valve disease in industrialized countries. The ageing population and the increase in comorbidities urge the development of safer alternatives to the current surgical treatment. Sutureless bioprosthesis have shown promising results, especially in complex procedures and in patients requiring concomitant surgeries. Objectives: Assess the clinical and hemodynamic performance, safety, and durability of the Perceval ® prosthetic valve. Methods: This single center retrospective longitudinal cohort study collected data of all adult patients with aortic valve disease who underwent aortic valve replacement with a Perceval ® prosthetic valve between February 2015 and October 2020. Of the 196 patients included (mean age 77.20±5.08 years; 45.4% female; mean EuroSCORE II 2.91±2.20%), the majority had aortic stenosis. Results: Overall mean cross-clamp and cardiopulmonary bypass times were 33.31±14.09 and 45.55±19.04 minutes, respectively. Mean ICU and hospital stay were 3.32±3.24 and 7.70±5.82 days, respectively. Procedural success was 98,99%, as two explants occurred. 4 valves were reimplanted due to intra-operative misplacement. Mean transvalvular gradients were 7.82±3.62 mmHg. Pacemaker implantation occurred in 12.8% of patients, new-onset atrial fibrillation in 21.9% and renal replacement support was necessary in 3.1%. Early mortality was 2.0%.  We report no structural valve deterioration, strokes or endocarditis and one successfully treated valve thrombosis. Conclusions: Our study confirms the excellent clinical and hemodynamic performance and safety of a truly sutureless aortic valve, up to 5-year follow-up. These results were consistent in isolated and concomitant interventions, solidifying this device as a viable option for treatment of isolated aortic valve disease.
20 Jun 2022Submitted to Journal of Cardiac Surgery
20 Jun 2022Assigned to Editor
20 Jun 2022Submission Checks Completed
21 Jun 2022Reviewer(s) Assigned