Aortic valve replacement with sutureless Perceval S bioprosthesis: Single-center experience

Introduction and objectives: Sutureless aortic valve replacement has emerged as an alternative for surgical treatment of severe aortic stenosis, especially in older patients. This is an observational, retrospective study of a group of patients from a single centre undergoing aortic valve replacement with Perceval S sutureless bioprosthesis (LivaNova, Saluggia, Italy). Methods: A total of 105 patients had an aortic valve replacement with a Perceval S bioprosthesis between June 2015 and October 2018. The combined procedures were, mitral valve replacement (n=1), tricuspid valve repair (n=2), myocardial revascularisation (n =16), and myectomy (n=1). The clinical and echocardiographic follow-up was performed at discharge, at 6 months, and yearly, after surgery. Results: The mean age was 80.5 +/- 3.8 years, and 57 (54.3%) were women. The mortality rate at 30 days was 1.9% (2 out of 105).The 30-day survival rate was 98%, and at one year it was 95%. The mean Euroscore II was 3.8% + 5.5%. The cardiopulmonary bypass and ischaemia times were 58.4 +/- 41.8 min, and 44 +/- 19.9 min for isolated aortic valve replacement, 94.2 +/- 44.1 min and 73.9 +/- 35.6 min for combined procedures, respectively. The mean trans-prosthetic gradient was 13.5 +/- 4.9 mmHg. The left ventricle function increased from 56.8% +/- 10.8% to 58.6% +/- 11.1%. Only 7 patients have required a definitive pacemaker implant (6.7%). Only 2 patients presented with a moderate para-valvular leak that did not require any treatment. Conclusions: Aortic valve replacement with the Perceval S sutureless bioprosthesis is associated with low mortality and excellent clinical and haemodynamic behaviour, especially in elderly patients. (C) 2019 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.