Sutureless aortic valve: Early and mid-term results at a single center

Amjad Shalabi, Ehud Raanani, Amihai Shinfeld, Rafael Kuperstein, Alexander Kogan, Alexander Lipey, Eyal Nachum, Dan Spiegelstein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Prolonged life expectancy has increased the number of elderly high risk patients referred for surgical aortic valve replacement (AVR). These referred high risk patients may benefit from sutureless bioprosthesis procedures which reduce mortality and morbidity. Objectives: To present our initial experience with sutureless aortic bioprotheses, including clinical and echocardiographic results, in elderly high risk patients referred for AVR. Methods: Forty patients (15 males, mean age 78 ± 7 years) with symptomatic severe aortic stenosis underwent AVR with the 3F Enable™ or Perceval™ sutureless bioprosthesis during the period December 2012 to May 2014. Mean logistic EuroScore was 10 ± 3%. Echocardiography was performed preoperatively, intraoperatively, at discharge and at follow-up. Results: There was no in-hospital mortality. Nine patients (22%) underwent minimally invasive AVR via a right anterior minithoracotomy and one patient via a J-incision. Four patients underwent concomitant coronary aortic bypass graft, two needed intraoperative repositioning of the valve, one underwent valve exchange due to inappropriate sizing, three (7.5%) had a perioperative stroke with complete resolution of neurologic symptoms, and one patient (2.5%) required permanent pacemaker implantation due to complete atrioventricular block. Mean preoperative and postoperative gradients were 44 ± 14 and 13 ± 5 mmHg, respectively. At follow-up, 82% of patients were in New York Heart Association functional class I and II. Conclusions: Sutureless AVR can be used safely in elderly high risk patients with relatively low morbidity and mortality. The device can be safely implanted via a minimally invasive incision. Mid-term hemodynamic results are satisfactory, demonstrating significant clinical improvement.

Original languageEnglish
Pages (from-to)119-123
Number of pages5
JournalIsrael Medical Association Journal
Volume18
Issue number2
StatePublished - Feb 2016

Keywords

  • Aortic valve replacement (AVR)
  • Aortic valve stenosis
  • High risk patients
  • Sutureless aortic valve
  • Transcatheter aortic valve implantation (TAVI)

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