Sutureless aortic valve replacement (SU-AVR) is a procedure for replacing the aortic valve without sutures. Researchers wanted to discuss the technical considerations of using the Perceval SU-AVR with concomitant mitral valve surgery, with or without tricuspid valve surgery. 30 patients with concomitant severe mitral valve disease, with or without tricuspid valve disease, underwent SU-AVR with the Perceval prosthesis in a single center from January 2013 to June 2016. The average age was (73.0± 6.6) years, with a range of 63 to 86 years, and 60% of the participants (n=18) were male. The study cohort’s mean logistic EuroScore was (9.8±4.6). Mitral valve repair (n=8, 26.6%), mitral valve replacement (n=22, 73.3%), tricuspid valve repair (n=18, 60%), tricuspid valve replacement (n=2, 6.6%), and cryoablation for atrial fibrillation (n=21, 70%) were all performed concurrently. The average prosthesis was 25 mm in length (large size). There were two deaths from noncardiac causes after a year. One patient (3.3%) had a third-degree atrioventricular block, necessitating the insertion of a permanent pacemaker.
The aortic prosthesis was successfully withdrawn and reimplanted in three patients (10%) who experienced intraoperative supra-annular malpositioning. For months, the average follow-up was (18±4.5). (maximum 3 years). The sinus rhythm restoration rate in patients who underwent the cryo-maze treatment was 76.1% (n=16) at discharge during the postoperative period. At follow-up, there was neither structural valve degradation nor prosthesis migration. Even in the face of multivalvular disease and atrial fibrillation surgery, Perceval SU-AVR is a technically possible and safe operation in patients with severe aortic stenosis.
Reference:www.jtcvs.org/article/S0022-5223(18)30407-0/fulltext
