Ricasoli Alessandro, Mignosa Carmelo, Lentini Salvatore, Asta Laura, Sbrigata Adriana, Altieri Claudia, Pisano Calogera
Cardiac Surgery Unit, University of Catania, 95124 Catania, Italy.
Cardiac Surgery Unit, Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy.
J Clin Med. 2025 Aug 21;14(16):5906. doi: 10.3390/jcm14165906.
The aim of this study is to analyze the effects of sutureless aortic valve bioprosthesis implantation compared with stented conventional bioprosthesis in patients with severe aortic stenosis. This is a propensity matching institutional study. : We compared 37 patients who underwent aortic valve replacement with Carpentier Edwards Perimount implantation (group 1) with 37 patients with sutureless Perceval S implanted (group 2). Preoperative, intraoperative, and postoperative parameters were studied. The cross-clamp time, the mechanical ventilation times, the intensive care unit, and the hospital stay were significantly shorter in group 2 than in group 1 (-value < 0.001). The cardio-pulmonary bypass time was 74 [45, 201] minutes in group 2 and 82 [48, 654] minutes in group 1 (-value = 0.113). The postoperative mean gradients were 13 [6, 44] mmHg in group 2 and 14 [6, 19] mmHg in group 1 (-value 0.285), and the effective orifice areas in these two groups were 1.5 ± 0.18 cm vs. 1.1 ± 0.4 cm ( 0.002). The percentage of minimally invasive approach was higher in group 2 than in group 1. The echocardiographic follow-up analysis showed that the mean and maximum gradients with a sutureless prosthesis implant were lower than that of a traditional prosthesis, although this difference was not statistically significant. The Perceval S valve seems to be an effective alternative solution for biological valve implantation with good hemodynamic characteristics as compared with Carpentier Edwards Perimount prosthesis, providing shorter ischemic and extracorporeal circulation time and better postoperative recovery. Perceval S valve implantation facilitates the minimally invasive approach.
本研究旨在分析与带支架传统生物瓣膜相比，无缝合主动脉瓣生物瓣膜植入术对重度主动脉瓣狭窄患者的影响。这是一项倾向性匹配的机构研究。我们将37例行Carpentier Edwards Perimount植入主动脉瓣置换术的患者（第1组）与37例行无缝合Perceval S植入术的患者（第2组）进行比较。研究了术前、术中和术后参数。第2组的主动脉阻断时间、机械通气时间、重症监护病房停留时间和住院时间均显著短于第1组（P值<0.001）。第2组的体外循环时间为74[45,201]分钟，第1组为82[48,654]分钟（P值=0.113）。第2组术后平均跨瓣压差为13[6,44]mmHg，第1组为14[6,19]mmHg（P值0.285），两组的有效瓣口面积分别为1.5±0.18cm²和1.1±0.4cm²（P值0.002）。第2组的微创入路百分比高于第1组。超声心动图随访分析显示，无缝合瓣膜植入的平均和最大跨瓣压差低于传统瓣膜，尽管这一差异无统计学意义。与Carpentier Edwards Perimount假体相比，Perceval S瓣膜似乎是一种有效的生物瓣膜植入替代解决方案，具有良好的血流动力学特性，缺血和体外循环时间更短，术后恢复更好。Perceval S瓣膜植入便于采用微创入路。
