French Thomas, Avtaar Singh Sanjeet Singh, Giordano Vincenzo, Koutsogiannidis Charilaos-Panagiotis, Lim Kelvin Hao Han, Pessotto Renzo, Zamvar Vipin
Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, United Kingdom.
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom.
World J Cardiol. 2025 Apr 26;17(4):102669. doi: 10.4330/wjc.v17.i4.102669.
The Perceval Sorin S (perceval valve) is a sutureless bioprosthetic designed for use in a high-risk cohort who may not be suitable for transcatheter aortic valve implantation or a conventional surgical aortic valve replacement (AVR).
To compare five-year post-operative outcomes in a cohort undergoing isolated AVR with the perceval valve to a contemporary cohort undergoing surgical AVR with a sutured bioprosthesis.
This study was a retrospective, cohort study at a single tertiary unit. Between 2017 and 2023, 982 suitable patients were identified. 174 Perceval valve replacements were matched to 174 sutured valve replacements. Cohort characteristics, intra-operative details, and post-operative outcomes were compared between the two groups.
Time under the aortic cross-clamp ( < 0.001), time on the cardiopulmonary bypass ( < 0.001) and total operative time ( < 0.001) were significantly reduced in the Perceval group. Patients in the Perceval valve group were at a lower risk of postoperative pneumonia [odds ratio (OR) = 0.53 (0.29-0.94)] and atrial fibrillation [OR = 0.58 (0.36-0.93)]. After propensity-matching, all-cause mortality did not significantly differ between the two groups in the five-year follow-up period. Larger valve sizes conferred an increased risk of mortality ( = 0.020).
Sutureless surgical AVR (SAVR) is a safe and efficient alternative to SAVR with a sutured bioprosthesis, and may confer a reduced risk of post-operative atrial fibrillation. Clinician tendency towards 'oversizing' sutureless aortic valves translates into adverse clinical outcomes. Less time on the cardiopulmonary bypass circuit allows for the treatment of otherwise high-risk patients.
Perceval Sorin S（Perceval瓣膜）是一种无缝合生物假体，设计用于可能不适合经导管主动脉瓣植入术或传统外科主动脉瓣置换术（AVR）的高危人群。
比较接受Perceval瓣膜单纯AVR的队列与接受缝合生物假体外科AVR的当代队列的术后五年结局。
本研究是在单一三级医疗单位进行的一项回顾性队列研究。2017年至2023年期间，确定了982例合适的患者。174例Perceval瓣膜置换术与174例缝合瓣膜置换术相匹配。比较两组的队列特征、术中细节和术后结局。
Perceval组的主动脉交叉阻断时间（<0.001）、体外循环时间（<0.001）和总手术时间（<0.001）显著缩短。Perceval瓣膜组患者术后发生肺炎的风险较低[比值比（OR）=0.53（0.29 - 0.94）]和心房颤动的风险较低[OR = 0.58（0.36 - 0.93）]。倾向匹配后，在五年随访期内两组的全因死亡率无显著差异。较大的瓣膜尺寸使死亡风险增加（=0.020）。
无缝合外科AVR（SAVR）是使用缝合生物假体的SAVR的一种安全有效的替代方法，可能会降低术后心房颤动的风险。临床医生对无缝合主动脉瓣“尺寸过大”的倾向会导致不良临床结局。体外循环时间较短允许治疗其他高危患者。
