Perceval Sutureless Aortic Valve Replacement in Octogenarian: A Treatment That Cheers Up Surgeons

DOI: 10.5083ejcm20424884.172 , Cite or Link Using DOI
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Ata EC, Erkanlı K

ABSTRACT Background: An increasing proportion of octogenarians undergo surgical aortic valve replacement. Although sutureless aortic prostheses have been developed to reduce the risks associated with cardioplegic ischemic time, its efficacy on high-risk octogenarian is still under investigation. Objective: To investigate the mid-term safety and efficacy of the Perceval sutureless aortic valve replacement (PSAVR) in octogenarians. Methods: This present study included 21 patients who underwent PSAVR between January 2016 and March 2018 at Medipol Mega University Hospital in Istanbul. Cardiac access was achieved either through full sternotomy or upper mini J-sternotomy. A Perceval valve with an appropriate size was implanted after resection of the aortic valve. Patients were periodically evaluated with by echocardiography. Results: Patients with severe aortic stenosis and regurgitation were 86% and 19% respectively. Four(19%) patients had undergone emergent surgery due to failed TAVI procedures. Full sternotomy was performed in 16(76.2%) patients; five(23.8%) patients operated via mini J-sternotomy. One patient was reexplorated due to massive bleeding 5 hours after the operation. Pneumonia and subsequent mortality occurred in this patient. Although 2 (9.6%) patients developed stroke, they recovered. Another four (19%) patients died from non-cardiac causes within two years follow up. Cardiac functional capacity improved in nearly all of the patients two years after surgery. Paravalvular leakage was not observed in any patient. Conclusion: The Perceval prosthesis has excellent mid-term results in the octogenarian, and high morbidity does not affect early postoperative mortality. Mid-term mortality is mainly related to non-cardiac causes.