Perceval Less Invasive Aortic Replacement Register: multicentric Spanish experience with the Perceval S bioprosthesis in moderate-high-risk aortic surgery
Por:
Garcia, EB, Rosell, MLC, Cid, FE, Dominguez, ES, Barrera, RR, Sbraga, F, Puente, JG, Diez, ER, Caballero, GPC, Munguira, JB, Copa, GR, Pajuelo, MT, Fiz, SS, Minano, JAB, Martin, IG, Castillo, JC, Lopez, SC, Pinto, AG and Baliarda, XR
Publicada:
1 abr 2018
Resumen:
OBJECTIVES: The development of new percutaneous and surgical techniques has reduced the risk associated with aortic valve replacement procedures. We present the results of a Spanish register after initiating a programme for sutureless prostheses in moderate-high-risk patients.
METHODS: This prospective multicentre study was carried out from November 2013 to November 2016. Data were obtained from 448 patients in whom a Perceval S prosthesis was implanted.
RESULTS: The mean age was 79.24 (standard deviation [SD] 4.1) years, and 61.2% were women. The estimated EuroSCORE I log risk was 11.15% (SD 7.6), with an observed mortality of 4.4% (20 patients). Isolated aortic valve replacement was performed on 69.26% of patients, with 64% involving ministernotomy. The incidence of neurological events was 2%, with 2 permanent cerebrovascular accidents, and 41 (9.2%) patients were implanted with a permanent endocavitary pacemaker. At discharge, 12 (2.6%) patients presented minimal periprosthetic leakage, and 4 (0.89%) patients had moderate leakage. There were 3 reinterventions during follow-up (2 endocarditis and 1 dysfunction due to periprosthetic leak progression). The mean gradient at discharge, 6 months and 1 year was 12.94 (SD 5.3) mmHg, 12.19 (SD 4.7) mmHg and 11.77 (SD 4.7) mmHg, respectively; 59.4% of the patients were octogenarians, with a survival rate of 98% at both 6 months and 1 year at discharge. There was neither valve migration nor early structural degeneration. The mean follow-up was 12 +/- 3 months. The 6-month and 1-year mortality was 1.4% and 2.1%, respectively.
CONCLUSIONS: This is a prospective multicentric study on the largest cohort of patients with sutureless valves conducted in Spain to date. It is a reproducible procedure that has enabled surgery on patients with a moderate-high risk with low morbidity and mortality, providing good haemodynamic results.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, Dept Cardiac Surg, Badalona, Spain
Rosell, MLC:
Hosp Badalona Germans Trias & Pujol, Dept Cardiac Surg, Badalona, Spain
Cid, FE:
Complejo Hosp Univ A Coruna, Dept Cardiac Surg, La Coruna, Spain
Dominguez, ES:
Hosp Infanta Cristina Badajoz, Dept Cardiac Surg, Badajoz, Spain
Barrera, RR:
Hosp Univ Vall dHebron, Dept Cardiac Surg, Barcelona, Spain
Sbraga, F:
Hosp Univ Bellvitge, Dept Cardiac Surg, Lhospitalet De Llobregat, Spain
Puente, JG:
Hosp Univ Virgen de la Arraixaca, Dept Cardiac Surg, Murcia, Spain
Diez, ER:
Hosp Santa Creu & Sant Pau, Dept Cardiac Surg, Barcelona, Spain
Caballero, GPC:
Hosp Univ Gregorio Maranon, Dept Cardiac Surg, Madrid, Spain
Munguira, JB:
Hosp Badalona Germans Trias & Pujol, Dept Cardiac Surg, Badalona, Spain
Hosp Univ La Princesa, Dept Cardiac Surg, Madrid, Spain
Copa, GR:
Hosp Univ La Princesa, Dept Cardiac Surg, Madrid, Spain
Pajuelo, MT:
Hosp Univ Dr Negrin, Dept Cardiac Surg, Las Palmas Gran Canaria, Spain
Fiz, SS:
Hosp Univ Puerta de Hierro, Dept Cardiac Surg, Madrid, Spain
Minano, JAB:
Hosp Univ Virgen Salud Toledo, Dept Cardiac Surg, Toledo, Spain
Martin, IG:
HUMV, Dept Cardiac Surg, Santander, Spain
Castillo, JC:
Complejo Hosp Univ A Coruna, Dept Cardiac Surg, La Coruna, Spain
Lopez, SC:
Hosp Univ Virgen de la Arraixaca, Dept Cardiac Surg, Murcia, Spain
Pinto, AG:
Hosp Univ Gregorio Maranon, Dept Cardiac Surg, Madrid, Spain
Baliarda, XR:
Hosp Badalona Germans Trias & Pujol, Dept Cardiac Surg, Badalona, Spain
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