title: A supra-annular malposition of the Perceval S sutureless aortic valve: the 'χ-movement' removal technique and subsequent reimplantation.
abstract: The Perceval S sutureless valve prosthesis has recently been introduced as a new biological aortic valve prosthesis, but a specific learning curve is required, as for every cardiac surgical centre dealing with a new technique. After the removal of the stenotic valve, the prosthetic valve is correctly positioned within the mildly decalcified aortic annulus. When a supra-annular malposition occurs, due to an excessively rapid release of the prosthesis in the aorta or incomplete annular visualization, the Perceval S valve can safely be removed even after balloon dilation. The procedure performed is a 'χ-movement' with the aid of anatomical forceps. If the prosthesis does not show any malformation after the procedure, it can be reimplanted in the correct intra-annular position.
authors.affiliation: Department of Cardiac Surgery, Klinikum Nürnberg, Nuremberg, Germany. g.santarpino@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.forename: Steffen
authors.initials: S
authors.lastname: Pfeiffer
authors.forename: Giovanni
authors.initials: G
authors.lastname: Concistrè
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D002404:Catheterization; D020878:Device Removal; D005858:Germany; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011474:Prosthesis Design; D016896:Treatment Outcome