Perceval sutureless aortic valve implantation: mid-term outcomes.

BACKGROUND: Since our center participated in the 'First-in-Man' trial with Perceval in 2007, this series represents the longest available clinical follow-up (11 years) with sutureless technology in aortic valve replacement. METHODS: We collected all clinical and echocardiographic follow-up in 468 consecutive patients who received Perceval at our institution between 2007 and 2017. In 57% of cases, surgery was combined with CABG (39%), mitral valve surgery (17%), or other procedures (13%). RESULTS: Mean age was 79y, mean EuroSCORE II was 5.1 ± 5.5 (range 0.8 to 67) and mean STS score was 5.8 ± 5.5. Mean cross-clamp times for isolated and combined procedures were 39 and 79 minutes respectively. Observed all-cause 30-day mortality was 3.2% with an early stroke rate of 1.8%. Pacemaker implantation rate was 7.9% overall, but only 3.9% in patients without pre-existing conduction or rhythm disorders. All-cause mortality at 1 and 2 years was 8.8 ± 1.3% and 13.2 ± 1.6% respectively. At the latest echocardiographic follow-up (mean 3y, range 1 to 11y), peak and mean gradients were 23 ± 10mmHg and 13 ± 6mmHg. During follow-up, we explanted 5 valves for endocarditis, and none for structural valve degeneration (SVD). CONCLUSIONS: After more than 11 years of continued clinical use of the Perceval sutureless valve, we observe low mortality and stroke rates, with good hemodynamic behaviour of the valve. None of our patients was reoperated for SVD. Because of the key benefits of this rapid-deployment valve, it has an added value in surgical aortic valve replacement.status: Published onlin