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Published on: December 11, 2017
Sutureless Valve Implantation in Sievers Type 0 Bicuspid Annuli: A Word of Caution
Marco Vola1, Jean-Baptiste Guichard2, Jean-François Fuzellier1
1Department of Cardiovascular, Cardiac Surgery Unit, University Hospital, St. Etienne, France.
Aim:
We describe a series of 3f Enable sutureless prostheses implanted in bicuspid valves.
Methods:
Between March 2011 and April 2014, five patients with Sievers type 0 bicuspid valves were selected to receive the sutureless 3f Enable prosthesis . Exclusion criteria were: intraoperative calibration of the aortic annulus >27 mm, left ventricle ejection fraction <50%, age <70 years.
Results:
All the implantations could be performed without the necessity to re-deploy the prosthesis . The perioperative transesophageal echocardiogragram detected two moderate paravalvular leakages (PVL) in two patients who received a large size of prosthesis (25 and 27 mm, respectively). The two leakages, at a follow-up of 32 and 24 months, respectively, increased to grade II and II +. No PVL appeared in the other three patients.
Conclusion:
This experience should warn about the inadequate performance of the 3f Enable valve in Sievers type 0 large aortic bicuspid annuli. In this subset any minor intraoperative residual leakage should not be accepted.
