Journal Article

Perceval sutureless bioprosthesis versus Perimount sutured bioprosthesis for aortic valve replacement in patients with aortic stenosis: a retrospective, propensity-matched study

Salmasi, Mohammed Yousuf, Quarto, Cesare, Zientara, Alicja, Kapadia, Sharan J, Roussin, Isabelle, Asimakopoulos, George

2024

Overview

Background Rapid-deployment aortic valve replacement (RDAVR) is an alternative to conventional AVR (cAVR) for aortic stenosis. Benefits include a reduction in operative times, facilitation of minimal access surgery and superior haemodynamics compared to conventional valves. However, further evidence is required to inform guidelines, preferably in the form of propensity-matched studies that include mid-term follow-up data. Methods This was a single-centre, retrospective, propensity-matched cohort study comparing the Perceval and conventional Perimount Magna Ease valve for short- and mid-term clinical parameters and size-matched mid-term echocardiographic parameters ( n  = 102 in both groups) from 2014 to 2020. Data were extracted from a nationally managed dataset. Results There were no demographic differences between the matched groups. The Perceval group had shorter cross-clamp time (Perceval 62 [49–81] minutes; Perimount 79 [63–102] minutes, P  < 0.001), shorter bypass time (Perceval 89 [74–114] minutes; Perimount 104 [84–137] minutes, P  < 0.001), and more frequent minimally-invasive approaches (Perceval 28%; Perimount 5%, P  < 0.001). Size-matched haemodynamics showed initially higher gradients in the Perceval group, but haemodynamics equalised at 12 + months. The Perceval group had a more favourable % change in the left ventricular posterior wall dimension at 2 + years (Perceval − 4.8 ± 18; Perimount 17 ± 2). Conclusions The Perceval facilitated shorter operations, which may benefit intermediate-high-risk, elderly patients with comorbidities requiring concomitant procedures. It also facilitated minimally invasive surgery. Size-matched haemodynamic performance was similar at mid-term follow-up, with the Perceval possibly better facilitating regression of left ventricular hypertrophy.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Aorta / Aortic stenosis / Aortic valve / Aortic Valve - surgery / Aortic valve implantation / Aortic valve stenosis / Aortic Valve Stenosis - etiology / Aortic Valve Stenosis - surgery / Bioprosthesis - adverse effects / Cardiac Surgery / Cardiology / Care and treatment / Cohort analysis / Cohort Studies / Comorbidity / Comparative analysis / Data collection / Heart / Heart Valve Prosthesis - adverse effects / Heart Valve Prosthesis Implantation - methods / Heart valves / Hemodynamics / Humans / Hypertrophy / Medicine / Medicine & Public Health / Minimally invasive aortic valve replacement / Minimally invasive surgery / Mortality / Pacemakers / Parameters / Patients / Prosthesis Design / Retrospective Studies / Statistical analysis / Surgeons / Surgery / Sutureless aortic valve replacement / Thoracic Surgery / Treatment Outcome / Ultrasonic imaging / Ventricle