PMID- 25106682
OWN - NLM
STAT- MEDLINE
DCOM- 20141211
LR  - 20141006
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 98
IP  - 4
DP  - 2014 Oct
TI  - Aortic valve replacement and concomitant procedures with the Perceval valve: 
      results of European trials.
PG  - 1294-300
LID - S0003-4975(14)01085-6 [pii]
LID - 10.1016/j.athoracsur.2014.05.033 [doi]
AB  - BACKGROUND: The Perceval (Sorin Group, Milan, Italy) is a self-anchoring 
      sutureless aortic valve prosthesis. We report the short- to midterm results of 
      combined aortic valve replacement (AVR) with concomitant procedures in elderly 
      patients undergoing operation as part of 3 consecutive prospective multicenter 
      European studies. METHODS: From April 2007 to February 2013, 243 patients (mean 
      age, 79.7 +/- 5.1 years; female patients, 61%; median EuroSCORE, 9%) underwent AVR 
      with concomitant procedures. The concomitant procedures were coronary artery 
      bypass grafting (CABG) (182 cases), septal myectomy (21 cases), CABG + other 
      procedures (18 cases), and 22 other procedures. Primary and secondary end points 
      included implant feasibility and safety (for mortality and morbidity) and 
      efficacy (New York Heart Association [NYHA] class improvement and hemodynamic 
      results) of the prosthesis at the different follow-up periods. Data were 
      expressed as mean +/- standard deviation. Kaplan-Meier analysis was performed for 
      survival analysis. RESULTS: Mean aortic cross-clamp and extracorporeal 
      circulation (ECC) times were 50.7 +/- 22.8 minutes and 78.9 +/- 32.3 minutes, 
      respectively. Thirty-day mortality was 2.1%. Mean postoperative gradient and 
      effective orifice area were 10.1 +/- 4.7 mm Hg and 1.5 +/- 0.4 cm(2) and 8.9 +/- 5.6 mm 
      Hg and 1.6 +/- 0.4 cm(2), respectively, at 1 year. There were early explantations, 
      4 of which resulted from paravalvular leaks. One additional valve explantation 
      resulted from aortic root bleeding, probably caused by excessively extensive 
      decalcification. In the late period, there was 1 mild paravalvular leak and no 
      intravalvular insufficiency. No migration, dislodgement, or degeneration of the 
      valve occurred during follow-up. Median follow-up was 444 days. CONCLUSIONS: 
      These trials confirm the safety and efficacy of the Perceval sutureless aortic 
      valve, especially in elderly patients requiring AVR + concomitant procedures. In 
      this patient group, sutureless valves may be advantageous compared to 
      transcatheter valve implantations as concomitant procedures other than 
      percutaneous coronary artery angioplasty are not always possible in the latter.
CI  - Copyright (c) 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Shrestha, Malakh
AU  - Shrestha M
AD  - Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, 
      Germany. Electronic address: shrestha.malakh.lal@mh-hannover.de.
FAU - Folliguet, Thierry A
AU  - Folliguet TA
AD  - Cardiac Medicosurgical Department, Institute Mutualiste Montsouris, Paris, 
      France.
FAU - Pfeiffer, Steffen
AU  - Pfeiffer S
AD  - Klinikum Nuernberg, Center of Cardiac Surgery, Nuremberg, Germany.
FAU - Meuris, Bart
AU  - Meuris B
AD  - Cardiac Surgery, U.Z. Gasthuisberg, Leuven, Belgium.
FAU - Carrel, Thierry
AU  - Carrel T
AD  - Inselspital, Bern, Switzerland.
FAU - Bechtel, Matthias
AU  - Bechtel M
AD  - Ruhr University of Bochum, Department of Cardiothoracic Surgery, Bochum, Germany.
FAU - Flameng, Willem J
AU  - Flameng WJ
AD  - Cardiac Surgery, U.Z. Gasthuisberg, Leuven, Belgium.
FAU - Fischlein, Theodor
AU  - Fischlein T
AD  - Klinikum Nuernberg, Center of Cardiac Surgery, Nuremberg, Germany.
FAU - Laborde, Francois
AU  - Laborde F
AD  - Cardiac Medicosurgical Department, Institute Mutualiste Montsouris, Paris, 
      France.
FAU - Haverich, Axel
AU  - Haverich A
AD  - Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20140805
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - Coronary Artery Bypass
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*methods/mortality
MH  - Humans
MH  - Male
MH  - Suture Techniques
EDAT- 2014/08/12 06:00
MHDA- 2014/12/17 06:00
CRDT- 2014/08/10 06:00
PHST- 2014/01/24 00:00 [received]
PHST- 2014/05/02 00:00 [revised]
PHST- 2014/05/08 00:00 [accepted]
PHST- 2014/08/10 06:00 [entrez]
PHST- 2014/08/12 06:00 [pubmed]
PHST- 2014/12/17 06:00 [medline]
AID - S0003-4975(14)01085-6 [pii]
AID - 10.1016/j.athoracsur.2014.05.033 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2014 Oct;98(4):1294-300. doi: 10.1016/j.athoracsur.2014.05.033. 
      Epub 2014 Aug 5.