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Aortic valve replacement with a conventional stented bioprosthesis versus sutureless bioprosthesis: A study of 763 patients

Lookup NU author(s): Dr Asif Shah, Dr Stephan Schueler, Stephen Clark

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Abstract

© 2018, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved. Objective: The aim of this retrospective study was to compare early postoperative outcomes after aortic valve replacement (AVR) with sutureless bioprostheses and conventional stented bioprostheses implanted through median sternotomy. Methods: From January 2011 to December 2016, 763 patients underwent aortic valve replacement with bioprostheses; of these, 139 received a Perceval S sutureless valve (Group A) and 624 received a Perimount Magna Ease valve (Group B). These groups were further divided into A1 (isolated Perceval AVR), A2 (Perceval AVR with coronary artery bypass grafting [CABG]), B1 (isolated conventional stented bioprosthesis), and B2 (conventional stented bioprosthesis + CABG). Results: Patients in Group A were older (mean 74 years vs. 71 years; P<0.0001), predominantly women (53% vs. 32%; P<0.0001), had a higher logistic EuroSCORE (3.26 vs. 2.43; P<0.001), more preoperative atrial fibrillation (20% vs. 13%; P=0.03), and had a lower reopening rate for bleeding (2.1% vs. 6.7%; P=0.04). Compared to Group B1, Group A1 had shorter cross-clamp (mean 40 min vs. 57 min; P≤0.0001) and bypass times (mean 63 min vs. mean 80 min; P=0.02), and they bled less postoperatively (mean 295 ml vs. mean 393 ml; P=0.002). The mean gradient across Perceval valve was 12.5 mmHg while its effective orifice area was 1.5 cm2. Conclusion: In our retrospective study of 763 patients, sutureless valve group patients are older, mostly women, more symptomatic preoperatively, and have higher logistic EuroSCORE. They have shorter cross-clamp and bypass times, less postoperative bleeding, and reduced incidence of reopening. Further studies are needed to evaluate the clinical benefits in short, mid, and long-terms.

Publication metadata

Author(s): Mujtaba SS, Ledingham SM, Shah AR, Pillay T, Schueler S, Clark S

Publication type: Article

Publication status: Published

Journal: Brazilian Journal of Cardiovascular Surgery

Year: 2018

Volume: 33

Issue: 2

Pages: 122-128

Print publication date: 01/04/2018

Acceptance date: 22/07/2017

ISSN (print): 0102-7638

ISSN (electronic): 1678-9741

Publisher: Sociedade Brasileira de Cirurgia Cardiovascular

URL: http://doi.org/10.21470/1678-9741-2017-0088

DOI: 10.21470/1678-9741-2017-0088

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