Clinical and hemodynamic outcomes of PERCEVAL'S sutureless bioprostheses implanted through a mini-approach in the aortic position

Aim. Aortic valve disease is one of three most common cardiovascular problems. Aortic stenosis is responsible for 70% of valve disease. Aortic valve replacement is the most effective treatment for aortic stenosis nowadays. A traditional suture technique of aortic valve replacement is associated with a high risk of complications. Most of these complications occur due to ischemic aortic cross-clamp time and comorbidities. Perceval S sutureless aortic valves to be implanted in selected patients are supposed to meet the challenge. The study was aimed at assessing Perceval S sutureless aortic valve hemodynamic and clinical parameters, its intraoperative advantages and postoperative complication rates. Methods. A prospective cohort study of Perceval S sutureless aortic valve implanted via J-sternotomy (n = 22) and median sternotomy (n = 10) was conducted. Early and medium postoperative clinical and functional outcomes were obtained and evaluated. Results. A decrease in the transaortic gradient was observed in early (peak gradient 21.6±4.2 (p = 0.1), mean gradient 11.3±2.8 (p = 0.58)) and medium (peak gradient 15.8±5.5 (p = 0.342), mean gradient 8.8±1.9 (p = 0.54)) follow-up. The myocardial mass index tended to be reduced throughout the entire follow-up (p = 0.01). There were no prosthesis dysfunctions or biodegradation. No patient died in the postoperative period. Survival at 36 months of follow-up was 93.75%. Conclusion. Perceval S xenopericardial sutureless aortic bioprostheses adequately resolve hemodynamic problems and improve left ventricle functional parameters in early and median follow-up. They may be recommended for elderly patients. Sutureless aortic valve implantation is technically feasible through J-sternotomy and contributes to an eventless follow-up.