title: Sutureless 3f Enable valve implantation concomitant with mitral valve surgery.
abstract: OBJECTIVE
  Interest in aortic sutureless bioprostheses is growing. Here, we evaluate the feasibility of performing aortic sutureless valve replacement concomitant with mitral valve surgery using the 3f Enable prosthesis.
  
  
  METHODS
  Of the 198 3f Enable® valve implantation procedures carried out in our unit between March 2011 and October 2014, 15 were performed concomitant with mitral valve surgery (8 bioprosthetic replacements and 7 annuloplasties).
  
  
  RESULTS
  The mean age and logistic EuroSCORE were 76 ± 6 years and 10.2 ± 4.8, respectively. The procedural success rate of aortic sutureless valve implantation was 100%. Mean cross-clamping and cardiopulmonary bypass times were 113.9 ± 35 and 150- ± 43 min, respectively. No reclamping in response to a sutureless paravalvular leakage (PVL) was needed. One grade 1 leak was observed at the time of discharge. There was no perioperative mortality. Pacemaker implantation was required in 1 case (6.6%). Initial follow-up (median = 8 months, range 1-6) showed no new aortic PVL; mean and peak transprosthetic gradients and the orifice area were 11.1 ± 2.5 and 18.4 ± 4.9 mmHg and 1.7 ± 0.4 cm(2), respectively. One grade 2 and two grade 1 mitral valve leaks were detected following annuloplasty.
  
  
  CONCLUSIONS
  3f Enable® sutureless valve implantation combined with mitral valve surgery appears feasible and the results presented here are encouraging. This procedure has the potential to simplify surgery in a cohort of high-risk patients for whom transcatheter aortic valve replacement is not an effective option. Larger studies should be conducted to confirm these observations.
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France marco.vola@univ-st-etienne.fr.
authors.forename: Marco
authors.initials: M
authors.lastname: Vola
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Campisi
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grinberg
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Morel
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Favre
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Iness
authors.initials: I
authors.lastname: Ayari
authors.affiliation: Cardiology Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Issaz
authors.affiliation: Cardiovascular Surgery Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Fuzellier
authors.affiliation: Cardiology Unit, Cardiovascular Diseases Department, University Hospital, Saint-Etienne, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Gerbay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005240:Feasibility Studies; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011474:Prosthesis Design; D013536:Suture Techniques
keywords: Aortic and mitral valve replacement; Sutureless heart valve prosthesis; Transcatheter aortic valve implantation