Sternal-sparing aortic valve replacement with sutureless valve in bicuspid valve

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Anatomical Variations

Background:

• Sutureless valves, like the Perceval valve, have emerged as an alternative to traditional stented valves for surgical aortic valve replacement (SAVR).
• Minimally invasive approaches such as right anterior thoracotomy (RAT) offer reduced surgical trauma compared to conventional sternotomy.
• Bicuspid aortic valve (BAV) anatomy, particularly the 2-sinus laterolateral phenotype, presents unique challenges for valve implantation due to an elliptical annulus.

Purpose of the Study:

• To describe the specific surgical technique for implanting the Perceval sutureless valve using a right anterior thoracotomy (RAT) approach.
• To address the challenges associated with implanting sutureless valves in patients with a 2-sinus bicuspid aortic valve (BAV).

Main Methods:

• Focus on the procedural details of SAVR using the Perceval valve.
• Utilized a right anterior thoracotomy (RAT) approach for minimally invasive access.
• Technique tailored for patients with the 2-sinus BAV laterolateral phenotype.

Main Results:

• The Perceval valve can be effectively implanted using the RAT approach in select BAV patients.
• Specific procedural modifications are necessary to accommodate the unique anatomy of the 2-sinus BAV.

Conclusions:

• The combination of the Perceval sutureless valve and the RAT approach is a viable option for SAVR in patients with 2-sinus BAV.
• Careful preoperative planning and surgical expertise are crucial for successful outcomes in these complex cases.