Outcome of a Modified Perceval Implantation Technique.

Authors:
Konstantin Zhigalov
Konstantin Zhigalov
Charité - Universitätsmedizin Berlin
Sabreen Mkalaluh
Sabreen Mkalaluh
University of Schleswig-Holstein
Lübeck | Germany
Marcin Szczechowicz
Marcin Szczechowicz
Universitätsklinikum Münster
Jerry Easo
Jerry Easo
University of Cologne
Germany
Harald C Eichstaedt
Harald C Eichstaedt
Texas Children's Hospital
United States
Alexander Weymann
Alexander Weymann
University of Heidelberg
Germany

Thorac Cardiovasc Surg 2019 Apr 19. Epub 2019 Apr 19.

Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

Background:  In our institution, we developed a modification of the standard implantation technique of the Perceval sutureless aortic prosthesis (LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. The technique has been described elsewhere. In this article, we present the results of our initial case series comprising 128 consecutive patients.

Methods:  From September 2016 to June 2018, 128 patients received a sutureless Perceval prosthesis (mean age 72.2 ± 8.5 years, 66 males). The data of the patients were prospectively collected in our general database and retrospectively analyzed using the SPSS software version 25 (IBM SPSS Inc., Chicago, Illinois, United States). Primary end points were primary implantation success and 30-day mortality. All patients underwent transthoracic echocardiography on discharge.

Results:  Our cohort consisted of real-world scenario patients with infective endocarditis, bicuspid aortic valves and one patient with left ventricular assist device. However, we had 100% primary implantation success with no need for valve explantation or paravalvular leaks. All-cause 30-day mortality was 2.3% (3 patients) with no cardiac deaths. Two patients (1.6%) had a permanent neurological deficit, three patients (2.3%) had new-onset renal dialysis, and four patients (3.1%) needed a permanent pacemaker postoperatively.

Conclusion:  To our knowledge, this is the first case series to report on a modified implantation technique of the Perceval prosthesis. The Perceval valve prosthesis produces excellent outcome in most pathologies, so that current contraindications should be revised.

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Source
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1685512
Publisher Site
http://dx.doi.org/10.1055/s-0039-1685512DOI Listing
April 2019
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