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Multicenter Study
. 2020 Feb;159(2):432-442.e1.
doi: 10.1016/j.jtcvs.2019.02.135. Epub 2019 May 11.

Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment

Augusto D'Onofrio  1 , Stefano Salizzoni  2 , Claudia Filippini  3 , Chiara Tessari  4 , Lorenzo Bagozzi  4 , Antonio Messina  5 , Giovanni Troise  5 , Margerita Dalla Tomba  5 , Manfredo Rambaldini  6 , Magnus Dalén  7 , Francesco Alamanni  8 , Massimo Massetti  9 , Carmelo Mignosa  10 , Claudio Russo  11 , Loris Salvador  12 , Roberto Di Bartolomeo  13 , Daniele Maselli  14 , Ruggero De Paulis  15 , Ottavio Alfieri  16 , Carlo Maria De Filippo  17 , Michele Portoghese  18 , Uberto Bortolotti  19 , Mauro Rinaldi  2 , Gino Gerosa  4
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Free article
Multicenter Study

Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment

Augusto D'Onofrio et al. J Thorac Cardiovasc Surg. 2020 Feb.
Free article

Abstract

Objectives: The aim of this retrospective multicenter study was to compare early clinical and hemodynamic outcomes of Perceval-S sutureless (Livanova, London, United Kingdom) and Intuity rapid-deployment (Edwards Lifesciences, Irvine, Calif) bioprostheses.

Methods: Data from patients who underwent isolated or combined aortic valve replacement with Perceval-S and with Intuity bioprostheses at 18 cardiac surgical institutions were analyzed. Propensity matching was performed to identify similar patient cohorts.

Results: We included 911 patients from March 2011 until May 2017. Perceval-S and Intuity valves were implanted in 349 (38.3%) and in 562 (61.7%) patients, respectively. Propensity score identified 117 matched pairs. In the matched cohort, device success was 99.1% and 100% in Perceval-S and Intuity group, respectively (P = 1.000). Thirty-day Valve Academic Research Consortium mortality occurred in 2 (1.7%) and 4 (3.4%) patients in the Perceval-S and in Intuity group, respectively (P = .6834). The rate of postoperative new permanent pacemaker implantation was 6% (7 patients) and 6.8% (8 patients) in the Perceval-S and in Intuity group, respectively (P = .7896). Perceval-S valve implantation requires significantly shorter aortic crossclamp and cardiopulmonary bypass times than Intuity valve implantation (aortic crossclamp time for isolated, 52 ± 14 minutes vs 62 ± 24 minutes; P < .0001). Peak transaortic gradients were 22.4 ± 8.1 mm Hg and 19.6 ± 6.7 mm Hg (P = .0144), whereas mean gradients were 11.8 ± 4.7 mm Hg and 10.5 ± 3.9 mm Hg (P = .0388) in the Perceval-S and Intuity groups, respectively.

Conclusions: Sutureless Perceval-S and rapid-deployment Intuity bioprostheses provide good and similar early clinical and hemodynamic outcomes. Perceval-S valve implantation requires shorter crossclamp and cardiopulmonary bypass times, whereas Intuity valve implantation provides lower transaortic peak and mean gradients.

Keywords: aortic valve; rapid deployment aortic bioprosthesis; replacement; sutureless aortic bioprosthesis.

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