title: Aortic valve replacement with the perceval S bioprosthesis: single-center experience in 143 patients.
abstract: OBJECTIVE
  Aortic stenosis (AS) is the most frequent heart valve disease in western countries, and its prevalence increases with age. Sutureless valves have recently become available that allow the surgical procedures to be shortened. The study aim was to assess clinical outcome after sutureless aortic valve replacement (SAVR) performed with the Perceval S bioprosthesis at the authors' institution.
  
  
  METHODS
  Between June 2007 and November 2011, a total of 143 patients (78 females, 65 males; mean age 79.4 +/- 5.9 years) was prospectively enrolled and followed at the authors' center. The median preoperative logistic EuroSCORE was 12.04 +/- 10.7. Preoperatively, 58.8% of patients were in NYHA class III or IV, and the mean gradient and effective orifice area (EOA) were 38.8 +/- 17 mmHg and 0.76 +/- 0.24 cm2, respectively. Isolated SAVR was performed in 95 patients (66.4%), while associated procedures were necessary in 48 patients (33.6%). The follow up was 100% complete (mean 13.4 +/- 11.6 months; range: 0-5 years; total cumulative follow up 155 patient-years).
  
  
  RESULTS
  The procedural success rate was 99.3%. The mean cross-clamp and cardiopulmonary bypass times were 32.0 +/- 14.9 min and 44.7 +/- 18.6 min, respectively. In-hospital mortality was 4.9% (n=7). Pacemaker implantation was required in seven patients (4.9%). Survival at five years was 85.5%. Reoperation was necessary in seven patients (4.9%); early reoperations were due to paravalvular leak (n = 3; 2.0%) and intra-prosthetic regurgitation (n=3; 2.0%). One late reoperation (at 29 months) was required, due to fibrous pannus overgrowth. One late endocarditis (0.7%) occurred at 26 months and was medically treated. No structural valve deterioration occurred during the follow up. At 12 months, 94.4% of survivors were in NYHA class I-II, and the mean pressure gradient and EOA were 9.0 +/- 3.4 mmHg and 1.60 +/- 0.3 cm2, respectively.
  
  
  CONCLUSIONS
  The Perceval S valve appears to be a safe option for SAVR, though further follow up is needed to evaluate the long-term outcome with this bioprosthesis.
authors: Konstantinos
authors: K
authors: Zannis
authors: Jérémie
authors: J
authors: Joffre
authors: Daniel
authors: D
authors: Czitrom
authors: Thierry
authors: T
authors: Folliguet
authors: Milena
authors: M
authors: Noghin
authors: Milena Noghin Emmanuel
authors: MN
authors: Lansac
authors: Laurens
authors: L
authors: Mitchell-Heggs
authors: Mathieu
authors: M
authors: Debauchez
authors: Francois
authors: F
authors: Laborde
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D001705:Bioprosthesis; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000401:mortality; D011474:Prosthesis Design; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome