Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Section of Cardiac Surgery, St. Boniface Hospital, University of Manitoba, Winnipeg, MB, Canada.
Innovations (Phila). 2024 Mar-Apr;19(2):125-135. doi: 10.1177/15569845241231989. Epub 2024 Mar 11.
The surgical treatment of aortic stenosis continues to evolve, and sutureless aortic valve replacement (SUAVR) is an emerging technology. With the Perceval S (Corcym, London, UK) as the only true sutureless valve on the market, the objective of this review is to analyze the current literature on Perceval S. Focusing on valve design and deployment as well as applications of the technology for challenging pathology, clinical outcomes are assessed, including a comparison with transcatheter AVR (TAVR).
PubMed and MEDLINE were searched by 3 authors for studies analyzing SUAVR from inception to May 19, 2023.
SUAVR facilitates minimally invasive surgery and offers an alternative strategy for patients with small aortic annuli. It also has a time-saving advantage for patients who require complex operations. SUAVR results in excellent long-term morbidity, mortality, durability, and hemodynamic function. In comparison with conventional surgical AVR (SAVR), SUAVR does have a greater risk of postoperative pacemaker implantation; however, increasing user experience and refinements in implantation technique have contributed to reductions in this outcome. SUAVR results in morbidity and mortality that is similar to rapid-deployment AVR. Midterm outcomes are superior to TAVR; however, further robust investigation into all of these comparisons is ultimately necessary.
SUAVR bridges the gap in technology between SAVR and TAVR. The application of this exciting technology will undoubtedly grow in the coming years, during which additional investigation is paramount to optimize preoperative planning, valve deployment, and reintervention strategies.
主动脉瓣狭窄的外科治疗仍在不断发展，无缝线主动脉瓣置换术（SUAVR）是一种新兴技术。随着 Perceval S（Corcym，伦敦，英国）成为市场上唯一真正的无缝线瓣膜，本综述的目的是分析目前关于 Perceval S 的文献。重点关注瓣膜设计和部署以及该技术在挑战性病理中的应用，评估临床结果，包括与经导管主动脉瓣置换术（TAVR）的比较。
由 3 位作者通过 PubMed 和 MEDLINE 搜索从开始到 2023 年 5 月 19 日分析 SUAVR 的研究。
SUAVR 促进了微创手术，并为小主动脉瓣环的患者提供了替代策略。对于需要复杂手术的患者，它也具有节省时间的优势。SUAVR 可实现出色的长期发病率、死亡率、耐久性和血液动力学功能。与传统的外科主动脉瓣置换术（SAVR）相比，SUAVR 术后更有可能需要植入起搏器；然而，随着用户经验的增加和植入技术的改进，这种结果有所减少。SUAVR 的发病率和死亡率与快速部署的 AVR 相似。中期结果优于 TAVR；然而，最终仍需要对所有这些比较进行更有力的调查。
SUAVR 弥合了 SAVR 和 TAVR 之间的技术差距。这项令人兴奋的技术的应用无疑将在未来几年增长，在此期间，额外的调查对于优化术前规划、瓣膜部署和再介入策略至关重要。
