CLINICAL AND ECHOCARDIOGRAPHIC FOLLOW-UP IN PATIENTS WITH SUTURELESS PERCEVAL BIOPROSTHESIS: SINGLE CENTER ANALYSIS IN 11 YEARS EXPERIENCE

Giovanni Concistrè, MD; Giacomo Bianchi, MD, PhD; Rafik Margaryan, MD, PhD; Edoardo Zancanaro, MD; Francesca Chiaramonti, MD, PhD; Enkel Kallushi, MD; Tommaso Gasbarri, MD, PhD; Michele Murzi, MD, PhD; Pierandrea Farneti, MD; Marco Solinas, MD.

 

ABSTRACT

Background:

We describe long-term clinical and echocardiographic follow-up in the largest single center cohort of patients underwent aortic valve replacement (AVR) with sutureless Perceval (CorCym, Italy) bioprosthesis.

Methods:

Between March 2011 and September 2022, 1237 patients underwent AVR with Perceval bioprosthesis implantation. Mean age was 78 ± 4 years and mean EuroSCORE II was 6.9 ± 2.8%. Concomitant procedures were performed in 272 patients (22%).

Results:

Thirty-day mortality was 1.37% (17/1237). 890 of 951 (93.5%) isolated AVR underwent minimally invasive surgery with a ministernotomy (n = 221) or right minithoracotomy (n = 669) approach. Cardiopulmonary bypass and aortic cross-clamp times were 80.6 ± 21.5 and 50.1 ± 10.5 minutes for isolated AVR and 145.8 ± 33.6 and 95.8 ± 20.7 minutes for combined procedures. At mean follow-up of 55.09 ± 6.7 months (range: 1-138.5 months), survival was 95.4% and mean transvalvular pressure gradient was 13.3 ± 4.2 mmHg. LV mass decreased from 153.5 g/m² to 114.6 g/m² (p< 0.001) and moderate paravalvular leakage occurred in 3 patients without hemolysis not requiring any treatment. Freedom from reoperation was 97.4%. Nine patients required surgical reintervention and 21 patients transcatheter valve-in-valve procedure for structural prosthesis degeneration at mean of 6.3 years after first operation (range: 2-10 years).

Conclusion:

AVR with Perceval bioprosthesis is associated with good clinical results and excellent hemodynamic performance in our eleven-years experience. Structural degeneration rate of Perceval is comparable with others bioprosthetic aortic valve. Sutureless technology may reduce operative time especially in combined procedures and enable minimally invasive AVR.

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