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Degenerated small Mitroflow aortic valves can be safely replaced with sutureless Perceval-S valves, offering improved hemodynamics and avoiding complications associated with other redo procedures.

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Mitroflow aortic valve bioprosthesis is favored for small aortic annuli due to favorable hemodynamics and ease of implantation.
  • However, early structural valve deterioration and high gradients are concerns, particularly in older patients with small prostheses.
  • Redo surgery in narrow, damaged annuli is challenging, and valve-in-valve transcatheter aortic valve implantation has limitations.

Purpose of the Study:

  • To evaluate the safety and efficacy of the Perceval-S sutureless aortic valve in patients with degenerated small Mitroflow valves.
  • To compare outcomes with conventional redo valve replacement and valve-in-valve transcatheter aortic valve implantation.

Main Methods:

  • A series of 8 patients with degenerated small Mitroflow valves underwent successful Perceval-S surgical sutureless aortic valve implantation.
  • Medium-term follow-up was conducted to assess clinical and hemodynamic outcomes.
  • Data on mortality, complications, and transvalvular pressure gradients were collected.

Main Results:

  • No early mortality occurred; one late death was due to unrelated gastrointestinal disease.
  • No major complications were observed postoperatively.
  • Low early and mid-term mean transvalvular pressure gradients were recorded (13.1 ± 3.3 mmHg and 10.2 ± 3.8 mmHg, respectively).

Conclusions:

  • Surgical sutureless aortic valve implantation with Perceval-S is a safe and effective alternative for patients with degenerated small Mitroflow valves.
  • This approach offers favorable clinical and hemodynamic results compared to conventional redo surgery or valve-in-valve transcatheter aortic valve implantation.
  • The sutureless solution presents a simpler, valid, and safer option for complex aortic valve replacement scenarios.