Early Outcomes of Sutureless Aortic Valve Replacement With the Perceval S Bioprosthesis.

ABSTRACT

BACKGROUND: Sutureless aortic valve replacement (SU-AVR) offers an alternative to traditional aortic valve replacement (AVR) and is becoming widely performed in many hospitals. The aim of the current study was to evaluate the early experience in SU-AVR with the Perceval S bioprosthesis at Monash Medical Centre. METHODS: Fifty-two (52) patients who underwent SU-AVR were retrospectively analysed (mean age 74.8±6.5years). Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30days after surgery, re-admissions and longer term echocardiographic data were collected from the relevant hospital databases. RESULTS: In isolated SU-AVR, the mean aortic cross-clamp and cardiopulmonary bypass times were 48.8 and 67.8minutes, respectively. There were no deaths within 30days after surgery. Rhythm disturbances developed in 46.2% of patients, with atrial fibrillation (32.7%) and heart block (9.6%) being most common. Mean and peak transaortic gradients reduced from 46.2 and 77.9mmHg preoperatively, to 10.7 and 19.7mmHg at 12 months postoperatively, respectively. CONCLUSIONS: The absence of early mortality and the satisfactory clinical and haemodynamic results demonstrated the overall safety and efficacy of the Perceval S valve. Although sutureless valves seem to be a promising alternative to traditional sutured valves, the high rate of new postoperative rhythm disturbances, particularly heart block, is potentially a concern with SU-AVR.