International Society For Minimally Invasive Cardiothoracic Surgery

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Outcomes Of A High Volume, Single Institutional Experience With The Perceval Sutureless Valve
Charlene E. Tennyson1, NADIM KHADEM2, Gunaratnam NIRANJAN,1, DAVID ROSE1, ANTONY WALKER1.

BACKGROUNDThe Perceval sutureless valve has been implanted in over 20, 000 patients in the last decade. The Lancashire cardiac centre has one of the highest implant rates in the UK. In this article we present our clinical outcomes. We hypothesise that sutureless valve implantation is a safe method of valve replacement in elderly patients with greater co-morbidities. METHODSClinical data was collected retrospectively for all patients receiving a Perceval sutureless valve between May 2013 and February 2018. Data were taken from the clinical records, the Patient Analysis and Tracking System and the Ormis electronic theatre records by an independent observer.
RESULTS225 (female 50.2%) patients were included. 123 (54.67%) isolated aortic valve replacements and 102 (45.33%) concomitant procedures. Average age at implantation was 78 years with an average additive Euro score of 9.03. Minimal access procedures were performed in 21 (9.33%) patients and 20 (8.89%) were redo operations. The average bypass and cross-clamp times were 98.88 and 64.62 minutes respectively.Postoperative complications included reoperation for bleeding (5.78%), postoperative neurological event (2.22%), permanent pacemaker (7.56%), renal impairment requiring temporary haemodialysis (4.5%) and respiratory failure requiring reintubation (7.56%).Survival at 30 days, 1, 3 and 5 years was 93.33%, 87.56%, 83.11% and 80.44% respectively.
CONCLUSIONSOur preliminary study has demonstrated that following a learning curve our 30-day mortality reduced after the 75th operation. Furthermore, our rate of permanent pacemaker insertion is consistent with rates of other European centres. Perceval is safe and easily reproducible, particularly in the elderly (71% survival at 30 days in nonagenarians).

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