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OBJECTIVE: To evaluate the postoperative outcomes of Perceval S sutureless bioprostesis in patients undergoing minimally invasive aortic valve replacement (MIAVR) through right anterior minitoracotomy (RT)
METHODS: From March 2011 to September 2012, 94 consecutive patients (mean age 77.2±6.5 years) underwent MIAVR through RT with Perceval S sutureless bioprostheses. RT was performed through a skin incision of 5-7 cm placed on the 2nd intercostal space. Direct aortic and percutaneous femoral cannulation were routinely used.
RESULTS: In-hospital mortality was 0% with a median predicted EuroSCORE of 9% (range 5%-30%). The mean aortic cross-clamp and cardiopulmonary bypass times were 42.7±13 and 72.5 ± 23 minutes, respectively. Median intensive care unit stay was 1 day (range 1-2 days) and patients were discharged after 6 (range 4-14) days. Stroke occurred in 1 patient. Incidence of permanent pacemaker was 0%. Hemodynamic at discharge showed good function of all Perceval S valves with low transvalvular pressure gradients (mean, 10 ± 4 mm Hg and peak, 21 ± 8 mm Hg). No migration or dislodgement of the valve occurred, but two mild paravalvular leakages were recorded. At median follow-up of 8 months, survival and freedom for reoperation were 100%, respectively.
CONCLUSIONS: In patients undergoing MIAVR through RT, the implantation of Perceval S sutureless bioprosthesis is simple and associated with excellent early clinical and hemodynamic outcomes. RT might be an alternative to TAVI procedures for high risk patients.