Eastern Cardiothoracic Surgical Society

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MINIMALLY INVASIVE SUTURELESS AORTIC VALVE REPLACEMENT WITH THE PERCEVAL S BIOPROSTHESIS THROUGH MINISTERNOTOMY: A SINGLE CENTRE EXPERIENCE
K Ramsaransing, V Hindori, A Kaya.
OLVG, Amsterdam, Netherlands.

OBJECTIVE: To report early postoperative outcomes and 1-year survival of patients undergoing sutureless aortic valve replacement with the Perceval S bioprosthesis through a ministernotomy.
METHODS: A total of 110 consecutive patients (52 males, mean age 74.2 6.1 years) underwent from February 2016 to March 2019 sutureless aortic valve replacement in our center with the Perceval S bioprosthesis through a ministernotomy. Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30 days after surgery and 1-year survival were assessed in all patients.
RESULTS: In-hospital mortality within 30 days after surgery was 0.9% (n=1, cause pneumonia). The mean cross-clamping time and extracorporeal circulation time were 5414 and 7821 minutes, respectively. No conversion to full median sternotomy was needed intra-operatively. Postoperative mean gradient was 11.2 2.8 mmHg, no major paravalvular leakage (PVL) or valve migration occurred postoperatively (trivial PVL in 1.8%, n=2). Postoperative re-sternotomy was needed in two patients due to pericardial effusion and tamponade. A definitive pacemaker implantation as a result of complete heart block was needed in 4 patients (3.6%). Postoperative ischemic stroke rate and new onset atrial fibrillation was 0.9% (n=1) and 20% (n=22), respectively. After 1-year of follow-up, overall survival was 98.1% (95% CI 93.3%-99.7%). Median intensive care unit and hospital stay was 1 and 8 day(s), respectively.
CONCLUSIONS: Minimally invasive sutureless aortic valve replacement with the Perceval S bioprosthesis through a ministernotomy appears to be a safe procedure with very good postoperative results and a 1-year survival. Further follow up is needed to evaluate long-term outcomes.


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