Biomechanical comparison of intuity vs. perceval aortic bioprosthesis: apples & oranges or swings & roundabouts?

Rapid deployment (RD) and sutureless (SU) aortic valve replacement (AVR) are established strategies with proven benefits and ongoing evolution. In this study, we compare the clinical results and technical attributes of RDAVR and SUAVR with the two most commonly applied bioprostheses, the Edwards Intuity Valve System and the Perceval sutureless.

N=19 patients with Intuity AVR were matched to N=19 with Perceval AVR from 2014 to 2020 at University Hospital Aachen, RWTH. Preoperative and postoperative data were compared. OSIRIX DICOM software was used for 4D stent analysis 30 days post-surgery. Additional in vitro evaluation of the Perceval and Intuity Valve Systems' radial forces was conducted.

In-hospital and 30-day mortality was 2/19(10.5%) in both groups. Patients in the Perceval group had higher MPG score value than those in the Intuity group (13.96 vs. 10.70; p=0.041). Patients in the Perceval group had significantly higher mean values of postoperative PPG than those in the Intuity group (26.34 vs. 19.52, p-value = 0.018). The Intuity group showed higher roundness in CT analyses after AVR and higher radial forces than the Intuity group during the in-vitro testing.

We report interesting differences regarding the biomechanical behavior of the stents' ovality and radial forces of the two prostheses. However, the early postoperative clinical outcome remains comparable. Further studies with larger cohorts and long-term mechanical analysis are needed for deeper insights into this complex entity.