Minimally invasive aortic valve replacement with Perceval S sutureless valve: early outcomes and one-year survival from two European centers.
OBJECTIVE
The aim of our study was to evaluate the early outcomes and 1-year survival of patients undergoing minimally invasive aortic valve replacement with the Perceval S sutureless valve for severe aortic stenosis.


METHODS
From March 2010 to March 2013, 281 high-risk patients underwent minimally invasive aortic valve replacement with the Perceval S sutureless valve through either right anterior minithoracotomy (n = 164) or upper ministernotomy (n = 117) at 2 cardiac centers.


RESULTS
The overall in-hospital mortality was 0.7% (2 patients). The overall median cardiopulmonary bypass and crossclamp time was 81 minutes (interquartile range, 68-98) and 48 minutes (interquartile range, 37-60), respectively. Postoperative stroke occurred in 5 patients (1.8%). The incidence of paravalvular leak greater than 1 of 4 and atrioventricular block requiring pacemaker implantation was 1.8% (5 patients) and 4.2% (12 patients), respectively. No migration occurred, and the mean postoperative gradient was 13 ± 4 mm Hg. At a median follow-up of 8 months (interquartile range, 4-14), the overall survival was 90%.


CONCLUSIONS
Minimally invasive aortic valve replacement with the Perceval S sutureless valve in high-risk patients is a safe and reproducible procedure associated with excellent hemodynamic results, postoperative outcomes, and 1-year survival.
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy; Bristol Heart Institute, Klinikum Nürnberg, Nürnberg, Germany. Electronic address: antoniomiceli79@alice.it.
Antonio
A
Miceli
University of Bristol, United Kingdom; and Cardiac Surgery, Klinikum Nürnberg, Nürnberg, Germany.
Giuseppe
G
Santarpino
University of Bristol, United Kingdom; and Cardiac Surgery, Klinikum Nürnberg, Nürnberg, Germany.
Steffen
S
Pfeiffer
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
Michele
M
Murzi
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
Daniyar
D
Gilmanov
University of Bristol, United Kingdom; and Cardiac Surgery, Klinikum Nürnberg, Nürnberg, Germany.
Giovanni
G
Concistré
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
Eugenio
E
Quaini
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
Marco
M
Solinas
University of Bristol, United Kingdom; and Cardiac Surgery, Klinikum Nürnberg, Nürnberg, Germany.
Theodor
T
Fischlein
Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
Mattia
M
Glauber
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D005060:Europe; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects / Q000401:mortality; D013908:Thoracotomy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome