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Sutureless aortic valve replacement with concomitant aortic arch reconstruction.

Ayaka Satoh1, Masaaki Ryomoto2, Naosumi Sekiya2

  • 1Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. ds28016@hyo-med.ac.jp.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
|June 9, 2020
PubMed
Summary

Sutureless aortic valve replacement (AVR) using the Perceval valve provided a successful treatment for a frail patient with severe aortic insufficiency and endoleak. This approach offers a viable option for complex aortic arch reconstruction and AVR in high-risk elderly individuals.

Keywords:
Aortic valve replacementPerceval bioprosthesisSutureless valveThoracic aortic aneurysm

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Aortic valve disease necessitates treatment, with standard aortic valve replacement (AVR) being the conventional approach.
  • Sutureless AVR presents a less invasive alternative for specific patient populations.
  • Complex cases involving aortic arch pathology and valve disease pose significant surgical challenges.

Observation:

  • An 82-year-old female patient presented with severe aortic insufficiency and a persistent type 1 endoleak post-TEVAR.
  • The patient was deemed frail and at high risk for conventional open-heart surgery.
  • A combined aortic arch reconstruction and sutureless AVR procedure was performed.

Findings:

  • The Perceval sutureless bioprosthesis was successfully implanted, offering a self-anchoring and self-expanding solution.
  • The patient experienced an uneventful postoperative course, demonstrating good tolerance to the procedure.
  • This case highlights the feasibility of combining complex aortic arch reconstruction with sutureless AVR.

Implications:

  • Sutureless AVR, specifically with the Perceval valve, may be a viable and safe option for high-risk elderly patients requiring combined aortic arch and valve surgery.
  • This approach could expand treatment options for complex aortic conditions in vulnerable patient populations.
  • Further research and case studies are warranted to validate the long-term efficacy and safety of this combined technique.