Ten-year experience with sutureless Perceval bioprosthesis: single-centre analysis in 1157 implants

Area of Science:

• Cardiology
• Cardiac Surgery
• Biomedical Engineering

Background:

• Aortic valve replacement (AVR) is a critical procedure for patients with aortic valve disease.
• Sutureless bioprosthetic valves aim to simplify implantation and potentially reduce procedure times.
• Long-term outcomes and structural valve degeneration rates are crucial for evaluating bioprosthetic device performance.

Purpose of the Study:

• To assess the long-term clinical and echocardiographic outcomes of the Perceval sutureless bioprosthesis in a large single-centre cohort.
• To evaluate the structural degeneration rate and reintervention requirements for the Perceval bioprosthesis over a 10-year period.
• To determine the safety and efficacy of sutureless technology in minimally invasive AVR procedures.

Main Methods:

• A retrospective analysis of 1157 patients who underwent AVR with the Perceval bioprosthesis between March 2011 and March 2021.
• Data collection included patient demographics, procedural details (including minimally invasive approaches), and peri-operative outcomes.
• Long-term follow-up assessed survival, hemodynamic performance (transvalvular pressure gradient), left ventricular mass, paravalvular leakage, and reoperation rates due to structural degeneration.

Main Results:

• Thirty-day mortality was 1.38%. Minimally invasive surgery was performed in 92% of isolated AVRs.
• At a mean follow-up of 53 months, survival was 96.5%, with a mean transvalvular pressure gradient of 13.7 mmHg.
• Freedom from reoperation was 97.6%. Structural degeneration led to reintervention in 27 patients (surgical or valve-in-valve) at a mean of 5.6 years post-implantation.

Conclusions:

• AVR with the Perceval bioprosthesis demonstrates favorable long-term clinical and hemodynamic results.
• The structural degeneration rate of the Perceval valve is comparable to other bioprosthetic valves.
• Sutureless technology facilitates minimally invasive AVR and may reduce operative times, particularly in combined procedures.