Minimally Invasive Aortic Valve Replacement with Sutureless Valves: Results From an International Prospective Registry
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study, Observational Study
- Keywords
- MICS, aortic stenosis, sutureless,
- MeSH
- Aortic Valve Stenosis surgery MeSH
- Sutureless Surgical Procedures methods statistics & numerical data MeSH
- Bioprosthesis MeSH
- Heart Valve Prosthesis Implantation methods statistics & numerical data MeSH
- Echocardiography methods MeSH
- Cardiac Surgical Procedures methods MeSH
- Cardiopulmonary Bypass statistics & numerical data MeSH
- Humans MeSH
- Minimally Invasive Surgical Procedures methods MeSH
- Prospective Studies MeSH
- Prosthesis Design trends MeSH
- Registries MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Heart Valve Prosthesis MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
OBJECTIVE: To report the early and mid-term results of patients who underwent minimally invasive aortic valve replacement (MI-AVR) with a sutureless prosthesis from an international prospective registry. METHODS: Between March 2011 and September 2018, among 957 patients included in the prospective observational SURE-AVR (Sorin Universal REgistry on Aortic Valve Replacement) registry, 480 patients underwent MI-AVR with self-expandable Perceval aortic bioprosthesis (LivaNova PLC, London, UK) in 29 international institutions through either minithoracotomy (n = 266) or ministernotomy (n = 214). Postoperative, follow-up, and echocardiographic outcomes were analyzed for all patients. RESULTS: Patient age was 76.1 ± 7.1 years; 64.4% were female. Median EuroSCORE I was 7.9% (interquartile range [IQR], 4.8 to 10.9). Median cardiopulmonary bypass and cross-clamp times were 81 minutes (IQR 64 to 100) and 51 minutes (IQR 40 to 63). First successful implantation was achieved in 97.9% of cases. Two in-hospital deaths occurred, 1 for noncardiovascular causes and 1 following a disabling stroke. In the early (≤30 days) period, stroke rate was 1.4%. Three early explants were reported: 2 due to nonstructural valve dysfunction (NSVD) and 1 for malpositioning. One mild and 1 moderate paravalvular leak were reported. In 16 patients (3.3%) pacemaker implantation was needed. Mean follow-up was 2.4 years (maximum = 7 years). During follow-up 5 explants were reported, 3 due to endocarditis and 2 due to NSVD. Follow-up stroke rate was 2.5%. Three structural valve deteriorations not requiring reintervention were reported. Five-year survival was 91.45%. CONCLUSIONS: In this large prospective international registry, MI-AVR with Perceval valve confirmed to be safe, reproducible, and effective in an intermediate-risk population, providing excellent clinical recovery both in early and mid-term follow-up.
CHUAC Complexo Hospital Universitario A Coruña Coruna Spain
Fondazione Poliambulanza Brescia Italy
Istituto Clinico Sant'Ambrogio Milan Italy
King's College Hospital London UK
Klinikum Nürnberg Paracelsus Medical University Nuremberg Germany
Ospedale del Cuore G Pasquinucci Massa Italy
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