Dokollari Aleksander, Torregrossa Gianluca, Bisleri Gianluigi, Hassanabad Ali Fatehi, Sa Michel Pompeu, Sicouri Serge, Veshti Altin, Prifti Edvin, Bacchi Beatrice, Cabrucci Francesco, Ramlawi Basel, Bonacchi Massimo
Department of Cardiac Surgery, Lankenau Heart Institute, Wynnewood, PA 19096, USA.
Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA 19096, USA.
J Cardiovasc Dev Dis. 2023 May 22;10(5):224. doi: 10.3390/jcdd10050224.
: The goal of this manuscript is to compare clinical and echocardiographic outcomes of patients undergoing aortic valve replacement (AVR) with Perceval sutureless bioprosthesis (SU-AVR) and sutured bioprosthesis (SB). : Following the PRISMA statement, data were extracted from studies published after August 2022 and found in PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS, and Google Scholar. The primary outcome of interest was post-procedural permanent pacemaker implantation, and the secondary outcomes were new left bundle branch block (LBBB), moderate/severe paravalvular leak (PVL), valve dislocation (pop-out), need for a second transcatheter heart valve, 30-day mortality, stroke, and echocardiographic outcomes. : Twenty-one studies were included in the analysis. When SU-AVR was compared to other SB, mortality ranged from 0 to 6.4% for Perceval and 0 to 5.9% for SB. Incidence of PVL (Perceval 1-19.4% vs. SB 0-1%), PPI (Perceval 2-10.7% vs. SB 1.8-8.5%), and MI (Perceval 0-7.8% vs. SB 0-4.3%) were comparable. In addition, the stroke rate was lower in the SU-AVR group when compared to SB (Perceval 0-3.7% vs. SB 1.8-7.3%). In patients with a bicuspid aortic valve, the mortality rate was 0-4% and PVL incidence was 0-2.3%. Long-term survival ranged between 96.7 and 98.6%. Valve cost analysis was lower for the Perceval valve and higher for sutured bioprosthesis. : Compared to SB valves, Perceval bioprosthesis has proved to be a reliable prosthesis for surgical aortic valve replacement due to its non-inferior hemodynamics, implantation speed, reduced cardiopulmonary bypass time, reduced aortic cross-clamp time, and shorter length of stay.
本手稿的目的是比较接受主动脉瓣置换术（AVR）的患者使用Perceval无缝合生物瓣膜（SU-AVR）和缝合生物瓣膜（SB）后的临床和超声心动图结果。遵循PRISMA声明，从2022年8月后发表的研究中提取数据，这些研究来自PubMed/MEDLINE、EMBASE、CENTRAL/CCTR、ClinicalTrials.gov、SciELO、LILACS和谷歌学术。感兴趣的主要结局是术后永久性起搏器植入，次要结局是新发左束支传导阻滞（LBBB）、中度/重度瓣周漏（PVL）、瓣膜脱位（弹出）、二次经导管心脏瓣膜需求、30天死亡率、中风和超声心动图结果。分析纳入了21项研究。当将SU-AVR与其他SB进行比较时，Perceval的死亡率为0%至6.4%，SB为0%至5.9%。PVL发生率（Perceval为1%至19.4%，SB为0%至1%）、PPI（Perceval为2%至10.7%，SB为1.8%至8.5%）和MI（Perceval为0%至7.8%，SB为0%至4.3%）具有可比性。此外，与SB相比，SU-AVR组的中风发生率更低（Perceval为0%至3.7%，SB为1.8%至7.3%）。在患有二叶式主动脉瓣的患者中，死亡率为0%至4%，PVL发生率为0%至2.3%。长期生存率在96.7%至98.6%之间。Perceval瓣膜的瓣膜成本分析较低，缝合生物瓣膜的成本较高。与SB瓣膜相比，Perceval生物瓣膜已被证明是一种可靠的用于外科主动脉瓣置换的瓣膜，因为其血流动力学不劣、植入速度快、体外循环时间缩短、主动脉阻断时间缩短且住院时间缩短。
