Conventional Prostheses versus Sutureless Perceval for Aortic Valve Replacement: A Meta-Analysis

Colarossi, Giorgia; Migliorini, Filippo; Becker, Michael; Arias, Jessica P; Autschbach, R.; Moza, Ajay; Aljalloud, Ali

doi:10.5761/atcs.ra.22-00125

Cited by 5 publications

(4 citation statements)

References 59 publications

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“…A metaanalysis revealed no signi cant difference in early mortality, perioperative complications, and paravalvular leakage between the Perceval and conventional prosthesis groups. Moreover, a shorter CPB time, aortic cross-clamping time, and higher pacemaker implantation rate were observed in the Perceval group [11]. Some reports revealed that the authors did not experience more failures or PVL when using Perceval in multiple valve procedures, which corroborates recent ndings [10,12].…”

Section: Discussionsupporting

confidence: 81%

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Yoshida

Hori

et al. 2023

Preprint

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Background Junctional epidermolysis bullosa is a rare skin and mucosal disorder characterized by blister formation in response to minor trauma and extracutaneous manifestations. There have been no reports of cardiac surgery and prognostication in patients with epidermolysis bullosa due to skin and mucosal fragility. Case presentation: A 55-year-old man presented with congenital junctional epidermolysis bullosa, hypertension, and vasospastic angina. He complained of dyspnea on exertion, and transthoracic echocardiography revealed severe aortic valve regurgitation, moderate aortic valve stenosis (tricuspid valve), and severe mitral valve regurgitation. Considering that the skin condition in the right chest wall was relatively healthy, the right thoracotomy approach was preferred and totally endoscopic concomitant mitral valve repair and aortic valve replacement were performed using a sutureless bioprosthetic valve (Perceval™ (Corcym, Group, Milan, Italy)). Polyurethane and silicon dressing foams were used to protect the skin at the site of contact with the bag valve mask, arterial pressure catheter, intravenous catheter, and the tracheal intubation tube. Vertical mattress sutures were used for the skin sutures. The postoperative course was uneventful, and the patient was discharged nine days after the operation. There was no indication for reoperation until three years follow-up period. Conclusions The totally endoscopic concomitant aortic and mitral valve surgery using Perceval™ prosthesis can be performed safely in patients with junctional epidermolysis bullosa by adequate protection of the skin and mucosa.

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Section: Discussionsupporting

confidence: 81%

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Yoshida

Hori

et al. 2023

Preprint

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show abstract

“…A meta-analysis revealed no significant difference in early mortality, perioperative complications, and paravalvular leakage between the Perceval and conventional prosthesis groups. Moreover, a shorter CPB time, aortic cross-clamping time, and higher pacemaker implantation rate were observed in the Perceval group [ 11 ]. Some reports revealed that the authors did not experience more failures or PVL when using Perceval in multiple valve procedures, which corroborates recent findings [ 10 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Yoshida,

Hori

et al. 2024

J Cardiothorac Surg

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Background Junctional epidermolysis bullosa is a rare skin and mucosal disorder characterized by blister formation in response to minor trauma and extracutaneous manifestations. There have been no reports of cardiac surgery and prognostication in patients with epidermolysis bullosa due to skin and mucosal fragility. Case presentation A 55-year-old man presented with congenital junctional epidermolysis bullosa, hypertension, and vasospastic angina. He complained of dyspnea on exertion, and transthoracic echocardiography revealed severe aortic valve regurgitation, moderate aortic valve stenosis (tricuspid valve), and severe mitral valve regurgitation. Considering that the skin condition in the right chest wall was relatively healthy, the right thoracotomy approach was preferred and totally endoscopic concomitant mitral valve repair and aortic valve replacement were performed using a sutureless bioprosthetic valve (Perceval™ (Corcym, Group, Milan, Italy)). Polyurethane and silicon dressing foams were used to protect the skin at the site of contact with the bag valve mask, arterial pressure catheter, intravenous catheter, and the tracheal intubation tube. Vertical mattress sutures were used for the skin sutures. The postoperative course was uneventful, and the patient was discharged nine days after the operation. There was no indication for reoperation until three years follow-up period. Conclusions The totally endoscopic concomitant aortic and mitral valve surgery using Perceval™ prosthesis can be performed safely in patients with junctional epidermolysis bullosa by adequate protection of the skin and mucosa.

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“…33,44 Still, in the absence of long-term data on PPI, the reliability of SV in younger patients is questionable. 45…”

Section: Discussionmentioning

confidence: 99%

Sutureless valves versus aortic root enlargement for aortic valve replacement in small aortic annulus: A systematic review and pooled analysis

Agarwal

Arnav

Ranjan

et al. 2023

Asian Cardiovasc Thorac Ann

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Background Very few studies provide direct comparisons between aortic root enlargement and sutureless valve implantation in patients with a small aortic annulus who underwent aortic valve replacement. This study aims to provide comparative outcomes between the two in such a subset of patients, through a systematic review and pool analysis. Methods The PubMed, Scopus and Embase databases were searched using the appropriate terms. The data from original articles mentioning aortic root enlargement and sutureless valves in a single or comparative study with another group of patients with a small aortic annulus were pooled and analyzed using descriptive statistics. Results Both cardiopulmonary bypass (68.4 vs. 125.03 min, p < 0.001) and aortic cross-clamp times were significantly shorter in the sutureless valve group, along with a concomitantly higher number of minimally invasive surgeries. The incidence of permanent pacemaker implantation (9.76% vs. 3.16%, p < 0.00001), patient prosthesis mis-match and paravalvular leak was significantly higher in the sutureless valve group. In comparison, the incidence of re-exploration for bleeding was higher in the aortic root enlargement group (5.27% vs. 3.16%, p < 0.02). The two groups had no differences in the duration of hospital stays or mortality. Conclusions Sutureless valves demonstrated a comparable hemodynamic outcome with aortic root enlargement in patients with a small aortic annulus. In addition to this, it greatly facilitated minimally invasive surgery. However, the high incidence of pacemaker implantation is still a concern for the widespread recommendation of sutureless valves, especially in young patients with a small aortic annulus.

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Conventional Prostheses versus Sutureless Perceval for Aortic Valve Replacement: A Meta-Analysis

Cited by 5 publications

References 59 publications

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Totally endoscopic concomitant aortic and mitral valve surgery in junctional epidermolysis bullosa: a case report

Sutureless valves versus aortic root enlargement for aortic valve replacement in small aortic annulus: A systematic review and pooled analysis

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