1. Midterm outcomes with a sutureless aortic bioprosthesis in a prospective multicenter cohort study
- Author
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Axel Haverich, Kavous Hakim-Meibodi, Bas A.J.M. de Mol, Martin Misfeld, Sabine Bleiziffer, Philippe Despins, Erwin S.H. Tan, Ulrike Carstens-Fitz, Riccardo Cocchieri, Axel Laczkovics, Elisa Cerutti, Otto Dapunt, Bart Meuris, Tomasz Niklewski, Harald C. Eichstaedt, Filip Casselman, Matthias Machner, Krzysztof J. Filipiak, Jan Gerhard Wimmer-Greinecker, Francesco Madonna, Eva Roost, Uday Sonker, Jean-Christian Roussel, Daniel Wendt, Wolfgang Harringer, Marian Zembala, Heinz Jakob, Tom Spyt, Malakh Shrestha, Peter Oberwalder, Thierry Folliguet, Rainald Seitelberger, Matthias Bechtel, Alain Prat, Pascal M. Dohmen, Samir Sarikouch, Mario Stalder, Jan Gummert, Theodor Fischlein, Xavier Roques, Steffen Pfeiffer, Willem Flameng, Carlo Banfi, Alfred Kocher, Thierry Carrel, Leonard Conradi, Hendrik Treede, Kostantinos Zannis, Giuseppe Santarpino, Alaaddin Yilmaz, Friedrich W. Mohr, Federico M. Asch, Cardiothoracic Surgery, ACS - Heart failure & arrhythmias, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Pulmonary and Respiratory Medicine ,Aortic valve ,medicine.medical_specialty ,sutureless aortic valve ,Population ,clinical and hemodynamic outcomes ,Hemodynamics ,030204 cardiovascular system & hematology ,Prosthesis Design ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Risk of mortality ,medicine ,Humans ,Prospective Studies ,education ,Aged ,Aged, 80 and over ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,education.field_of_study ,business.industry ,Aortic Valve Stenosis ,medicine.disease ,Confidence interval ,Surgery ,multicenter study ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Heart Valve Prosthesis ,Aortic Valve ,Concomitant ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
Objective The objective of this study was to report midterm clinical outcomes with a self-expandable sutureless aortic valve. Methods Between 2010 and 2013, 658 patients at 25 European institutions received the Perceval sutureless valve (LivaNova Plc, London, United Kingdom). Mean follow-up was 3.8 years; late cumulative follow-up was 2325.2 patient-years. Results The mean age of the population was 78.3 ± 5.6 years and 40.0% (n = 263) were 80 years of age or older; mean Society of Thoracic Surgeons-Predicted Risk of Mortality score was 7.2 ± 7.4. Concomitant procedures were performed in 31.5% (n = 207) of patients. Overall duration of cardiopulmonary bypass time was 64.8 ± 25.2 minutes and aortic cross-clamping time was 40.7 ± 18.1 minutes. Thirty-day all-cause mortality was 3.7% (23 patients), with an observed:expected ratio of 0.51. Overall survival was 91.6% at 1 year, 88.5% at 2 years, and 72.7% at 5 years. Peak and mean gradients remained stable during follow-up, and were 17.8 ± 11.3 mm Hg and 9.0 ± 6.3 mm Hg, respectively, at 5 years. Preoperatively, 33.4% of those who received the Perceval valve (n = 210) were in New York Heart Association functional class I or II versus 93.1% (n = 242) at 5 years. Conclusions This series, representing, to our knowledge, the longest follow-up with sutureless technology in a prospective, multicenter study, shows that aortic replacement using sutureless valves is associated with low mortality and morbidity and good hemodynamic performance.
- Published
- 2022
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