Department of Cardiothoracic Surgery, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal.
Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
J Card Surg. 2022 Dec;37(12):4774-4782. doi: 10.1111/jocs.17113. Epub 2022 Nov 6.
Aortic valve stenosis is the most common adult valve disease in industrialized countries. The aging population and the increase in comorbidities urge the development of safer alternatives to the current surgical treatment. Sutureless bioprosthesis has shown promising results, especially in complex procedures and in patients requiring concomitant surgeries.
Assess the clinical and hemodynamic performance, safety, and durability of the Perceval® prosthetic valve.
This single-center retrospective longitudinal cohort study collected data from all adult patients with aortic valve disease who underwent aortic valve replacement with a Perceval® prosthetic valve between February 2015 and October 2020. Of the 196 patients included (mean age 77.20 ± 5.08 years; 45.4% female; mean EuroSCORE II 2.91 ± 2.20%), the majority had aortic stenosis.
Overall mean cross-clamp and cardiopulmonary bypass times were 33.31 ± 14.09 min and 45.55 ± 19.04 min, respectively. Mean intensive care unit and hospital stay were 3.32 ± 3.24 days and 7.70 ± 5.82 days, respectively. Procedural success was 98.99%, as two explants occurred. Four valves were reimplanted due to intraoperative misplacement. Mean transvalvular gradients were 7.82 ± 3.62 mmHg. Pacemaker implantation occurred in 12.8% of patients, new-onset atrial fibrillation in 21.9% and renal replacement support was necessary for 3.1%. Early mortality was 2.0%. We report no structural valve deterioration, strokes, or endocarditis, and one successfully treated valve thrombosis.
Our study confirms the excellent clinical and hemodynamic performance and safety of a truly sutureless aortic valve, up to a 5-year follow-up. These results were consistent in isolated and concomitant interventions, solidifying this device as a viable option for the treatment of isolated aortic valve disease.
主动脉瓣狭窄是工业化国家最常见的成人瓣膜疾病。人口老龄化和合并症的增加促使人们开发出比当前手术治疗更安全的替代方法。无缝线生物瓣已显示出良好的效果，特别是在复杂手术和需要同时进行手术的患者中。
评估 Perceval® 人工瓣膜的临床和血液动力学性能、安全性和耐久性。
这是一项单中心回顾性纵向队列研究，从 2015 年 2 月至 2020 年 10 月期间接受 Perceval® 人工瓣膜主动脉瓣置换术的所有成年主动脉瓣疾病患者中收集数据。196 例患者中（平均年龄 77.20±5.08 岁；45.4%为女性；平均 EuroSCORE II 为 2.91±2.20%），大多数为主动脉瓣狭窄。
总体平均体外循环和心肺转流时间分别为 33.31±14.09 分钟和 45.55±19.04 分钟。平均重症监护病房和住院时间分别为 3.32±3.24 天和 7.70±5.82 天。手术成功率为 98.99%，有 2 例需要再次取出。由于术中位置不当，有 4 个瓣膜需要重新植入。平均跨瓣梯度为 7.82±3.62mmHg。12.8%的患者需要植入起搏器，21.9%的患者新发心房颤动，3.1%的患者需要肾脏替代支持。早期死亡率为 2.0%。我们报告没有结构性瓣膜恶化、中风或心内膜炎，只有 1 例成功治疗的瓣膜血栓形成。
我们的研究在 5 年的随访中证实了真正无缝线主动脉瓣的出色临床和血液动力学性能以及安全性。这些结果在单纯和合并干预中是一致的，这使得该装置成为治疗单纯主动脉瓣疾病的可行选择。
