Universität zu Köln

Koenig, Karl Christian, Wahlers, Thorsten, Scherner, Maximilian and Wippermann, Jens (2014). Suture less Perceval Aortic Valve in Comparison with the Stented Carpentier-Edwards Perimount Aortic Valve. J. Heart Valve Dis., 23 (2). S. 253 - 259. NORTHWOOD: I C R PUBLISHERS. ISSN 0966-8519

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Abstract

Background and aim of the study: The Sorin Perceval S (SP) sutureless bioprosthesis was developed as an advancement of conventional biological aortic valve replacement (AVR) with stented bioprostheses, and perhaps also as an alternative to the transcatheter aortic valve implantation (TAVI) procedure, especially for high-risk patients. Herein are described the authors' early results with SP valve replacement, compared to AVR with Carpentier-Edwards Perimount (EP) stented valves. Methods: Between September 2012 and February 2013, a total of 14 patients was enrolled in a single-center SP study group, and their data were analyzed in a prospective manner. For comparison, 14 patients who received an EP valve replacement during the same period were matched with the SP group, in a retrospective manner. Hemodynamic parameters and clinical outcome were monitored until discharge of the patients in order to analyze the early results of the two groups. Results: The cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) times needed for AVR with SP valves were significantly shorter than with EP valves. The mean CPB time for SP valve replacement without concomitant procedures was 58.4 +/- 11.0 min, compared to 71.8 +/- 11.3 min in the EP group (p = 0.015), while the mean ACC times were 37.3 +/- 6.8 and 49.1 +/- 11.2 min, respectively (p = 0.006). Permanent pacemaker implantation was required in four patients after SP valve replacement, but in only one patient after EP valve replacement (p = 0.326). The mean transprosthetic peak and mean gradients were 24.8 +/- 5.2 mmHg and 13.3 +/- 3.3 mmHg, respectively, in the SP group, and 19.0 +/- 6.5 mmHg and 10.4 +/- 3.0 mmHg, respectively, in the EP group (p = 0.024 and p = 0.087). The mean valve size was 23.8 +/- 1.3 mm and 23.3 +/- 1.5 mm in the SP and EP groups, respectively. The fall in platelet count after SP valve replacement was 180.4 +/- 79.4 x 10(3)/mu l on the first postoperative day (POD), and 114.1 +/- 51.2 x 10(3)/mu l with a minimum of 42 x 10(3)/mu l and a maximum of 230 x 10(3)/mu l at the nadir on POD 2.6 +/- 4.0. The mean minimum values at the nadir corresponded to 40% of the initial preoperative value. Conclusion: The sutureless SP bioprosthesis seems to represent a good alternative to conventional stented bioprostheses, especially in older patients with a high-risk profile, and particularly if concomitant surgical procedures are planned.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koenig, Karl Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-445394
Journal or Publication Title:	J. Heart Valve Dis.
Volume:	23
Number:	2
Page Range:	S. 253 - 259
Date:	2014
Publisher:	I C R PUBLISHERS
Place of Publication:	NORTHWOOD
ISSN:	0966-8519
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FREEDOM SOLO; BIOPROSTHESIS; REPLACEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44539