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AORTIC VALVE REPLACEMENT WITH SUTURELESS PERCEVAL BIOPROSTHESIS: SINGLE CENTER EXPERIENCE WITH 517 IMPLANTS
Giovanni Concistrč, Francesca Chiaramonti, Giacomo Bianchi, Michele Murzi, Egidio Varone, Tommaso Gasbarri, Filippo Santarelli, Enkel Kallushi, Alfredo Cerillo, Pierandrea Farneti, Marco Solinas.
Ospedale del cuore "G. Pasquinucci" - Fondazione G. Monasterio CNR, Massa, Italy.
OBJECTIVE: Patients referred for aortic valve replacement (AVR) may benefit from sutureless technology in order to reduce mortality, morbidity and facilitate minimally invasive approach. We describe our experience with sutureless Perceval (Sorin Group, Italy) aortic bioprosthesis.
METHODS: Between March 2011 and January 2015, 517 patients underwent AVR with Perceval bioprosthesis. Mean age was 76 ± 7 years, 331 patients were female (64%), and mean logistic EuroSCORE was 12.2 ± 10.4%. Concomitant procedures were mitral valve surgery (n = 74), tricuspid valve repair (n = 21), CABG (n = 41), miectomy (n = 3) and ascending aorta replacement (n = 2).
RESULTS: In-hospital mortality was 1.5% (8/517). 385 (74.5%) patients underwent minimally invasive AVR with an upper ministernotomy (n = 55) or right anterior minithoracotomy (n = 330) approach. Cardiopulmonary bypass and aortic cross-clamp times were 81.2 ± 36.7 and 50.8 ± 25.1 minutes for isolated AVR and 138.2 ± 56.3 and 91.1 ± 34 minutes for combined procedures. At mean follow-up of 19.3 months (range: 0-52.7 months), survival was 91%, freedom from reoperation was 99%, and mean transvalvular pressure gradient was 11.4 ± 5.4 mmHg.
CONCLUSIONS: AVR with Perceval bioprosthesis is a safe and feasible procedure associated with low mortality and excellent hemodynamic performance.
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