Isolated Aortic Valve Replacement with Sutureless Prothesis by Surgical Approach from the Multicentric MANTRA Study

Objective

Minimally invasive approaches to aortic valve replacement (AVR) are recently increasing. However, median sternotomy is still widely used. This analysis aims to evaluate benefits of minimally invasive (MICS) versus median sternotomy (MS) in AVR using the Perceval Plus sutureless bioprosthesis.

Methods

MANTRA is a prospective, multicenter study designed to collect clinical and echocardiographic data on various Corcym devices with up to 10 years of follow-up. This analysis focuses on patients who underwent isolated AVR (N=198) using the Perceval Plus between July 2021 and June 2024, comparing those treated with MS access (N=55) with those treated with MICS (N=143) in 30 centers worldwide. Clinical and hemodynamic outcomes, KCCQ-12 and EQ-5D-5L quality of life (QoL) questionnaires were collected preoperatively, at 30 days, and at 1 year. Serious adverse events, both early (≤30 days) and late, were assessed according to VARC-3 criteria. All patients completed the 30-day follow-up, and 73.3% of the expected 1-year follow-up data were available at the time of this analysis. This study is ongoing.

Conclusions

Minimally invasive approach with sutureless prosthesis did not lead to statistically increased surgical times and resulted in a reduced ICU length of stay. No other significant differences were found. Minimally invasive is safe as sternotomy, with advantages of reduced surgical trauma and cosmetics benefits.