Early aortic dissection after aortic valve replacement with a Perceval sutureless bioprosthesis

Area of Science:

• Cardiovascular Surgery
• Medical Device Complications
• Aortic Diseases

Background:

• Aortic valve replacement is a common procedure.
• Sutureless bioprostheses offer potential advantages in surgical time and technique.
• Complications associated with novel device implantation require careful monitoring.

Observation:

• A patient developed ascending aorta dissection post-aortic valve replacement with a Perceval sutureless pericardial bioprosthesis.
• The intimal tear was identified at the aortotomy suture line during reoperation.
• The nitinol stent tips were distant from the dissected aortic segment.

Findings:

• The observed aortic dissection was not directly attributable to the Perceval bioprosthesis itself.
• The complication's location suggests it was related to the aortotomy closure rather than device impingement.
• A prior report links transcatheter prosthesis struts to aortic wall erosion.

Implications:

• While not directly caused by the device, this case highlights a potential, albeit rare, complication associated with sutureless aortic valve prostheses.
• Further investigation into the biomechanical interaction between sutureless devices and the aortic wall is warranted.
• This finding may inform future device design and surgical techniques to mitigate dissection risk.