Novel Treatment of a Degenerated Bioroot With the Use of the Sutureless Valve Technique

Stoker, Thijs; Mashhour, Ahmed; Easo, Jerry; Kronberg, Kay; Ennker, Jürgen; Weymann, Alexander

doi:10.1016/j.athoracsur.2017.11.059

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…The data of a total of 17 patients in whom a failing stentless bioprosthesis was replaced with an SB ( n = 14) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ] or an RDB ( n = 3) [ 21 , 22 ] were collected. In fact, one patient has been reported about twice [ 14 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

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Sutureless and rapid-deployment bioprostheses have been introduced as alternatives to traditional prosthetic valves to reduce cardiopulmonary and aortic cross-clamp times during aortic valve replacement. These devices have also been employed in extremely demanding surgical settings, as underlined in the present review. Searches on the PubMed and Medline databases aimed to identify, from the English-language literature, the reported cases where both sutureless and rapid-deployment prostheses were employed in challenging surgical situations, usually complex reoperations sometimes even performed as bailout procedures. We have identified 25 patients for whom a sutureless or rapid-deployment prosthesis was used in complex redo procedures: 17 patients with a failing stentless bioprosthesis, 6 patients with a failing homograft, and 2 patients with the failure of a valve-sparing procedure. All patients survived reoperation and were reported to be alive 3 months to 4 years postoperatively. Sutureless and rapid-deployment bioprostheses have proved effective in replacing degenerated stentless bioprostheses and homografts in challenging redo procedures. In these settings, they should be considered as a valid alternative not only to traditional prostheses but also in selected cases to transcatheter valve-in-valve solutions.

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Section: Resultsmentioning

confidence: 99%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

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“…The integrity of the aortic root persists through the full root technique and contributes to the long-term structural stability. On the other hand, re-root replacement can be a hazardous procedure, so that treatment for degenerated roots however may be facilitated by TAVI treatment or implantation of rapid deployment valves in a valve-in-root procedure, described by the authors institution 23 .…”

Section: Resultsmentioning

confidence: 99%

Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients

Easo

Weymann

Hölzl

et al. 2019

Sci Rep

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Our aim was to analyse the hospital outcome for the worldwide largest series of stentless bioroot xenografts (Medtronic Freestyle) as full root replacement in a single centre over a period of 18 years. Retrospective data analysis was performed for the entire cohort of patients undergoing aortic root surgery with the Medtronic Freestyle valve prosthesis. Logistic regression analysis was performed to analyse predictors of in-hospital mortality. 971 patients underwent aortic full root replacement with the Medtronic Freestyle valve in the period from 1999–2017, with an average age of 68.8 ± 10.3y and gender distribution of 608:363 (male:female). Concomitant surgery was performed in 693 patients (71.4%). In-hospital all-comers mortality was 9.8% (95 patients), with the respective highest risk profiles including dissections (6.4%), endocarditis (5.6%) and re-do procedures (12.5%). In-hospital mortality for elective patients was 7.6% while isolated aortic root replacement demonstrated a mortality of 3.6%. Logistic regression analysis demonstrated age (OR 1.05, p = 0.005), dissection (OR 5.78, p < 0.001) and concomitant bypass surgery (OR 2.68, p < 0.001) as preoperative risk factors for the entire cohort. Postoperative analysis demonstrated myocardial infarction (OR 48.6, p < 0.001) and acute kidney injury (OR 20.2, p < 0.001) to be independent risk factors influencing mortality. This analysis presents a work-through of all patients with stentless bioroot treatment without positive selection in a high-volume clinical center with the largest experience world-wide for this form of complex surgery. Isolated aortic root replacement could be performed at acceptable operative risk for this technically-challenging procedure.

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“…20 Only few small case series were presented in this subject, including one from our institution. 5,[21][22][23] Of the 18 endocarditis patients, 11 had previous valve surgery and 12 had severe aortic insufficiency. While the mean logistic EuroSCORE of this subgroup was 19.4, only one early mortality occurred.…”

Section: Aortic Valve Endocarditismentioning

confidence: 99%

“…3 Sutureless valve prostheses are fairly a compromise between conventional aortic valve prostheses and TAVI, which offer excellent hemodynamics, are more appealing for minimally invasive procedures and their implantation technique involves removal of the calcific native valve. The Perceval prosthesis (LivaNova, London, United Kingdom) is currently the only true sutureless aortic valve prosthesis on the market 4,5 which can also be used as a bail-out prosthesis in the mitral position 6 as an out-of-the-box alternative to patching annular abscesses or to keep a heavily calcified mitral annulus intact. 7 We published earlier a modification of the implantation technique of the Perceval prostheses, which involves the use of elastic snuggers tightened over the three guiding sutures to fix the prothesis to the aortic annulus prior to the deployment.…”

Section: Introductionmentioning

confidence: 99%

Outcome of a Modified Perceval Implantation Technique

Mashhour

Zhigalov

Mkalaluh

et al. 2019

Thorac Cardiovasc Surg

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Background In our institution, we developed a modification of the standard implantation technique of the Perceval sutureless aortic prosthesis (LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. The technique has been described elsewhere. In this article, we present the results of our initial case series comprising 128 consecutive patients. Methods From September 2016 to June 2018, 128 patients received a sutureless Perceval prosthesis (mean age 72.2 ± 8.5 years, 66 males). The data of the patients were prospectively collected in our general database and retrospectively analyzed using the SPSS software version 25 (IBM SPSS Inc., Chicago, Illinois, United States). Primary end points were primary implantation success and 30-day mortality. All patients underwent transthoracic echocardiography on discharge. Results Our cohort consisted of real-world scenario patients with infective endocarditis, bicuspid aortic valves and one patient with left ventricular assist device. However, we had 100% primary implantation success with no need for valve explantation or paravalvular leaks. All-cause 30-day mortality was 2.3% (3 patients) with no cardiac deaths. Two patients (1.6%) had a permanent neurological deficit, three patients (2.3%) had new-onset renal dialysis, and four patients (3.1%) needed a permanent pacemaker postoperatively. Conclusion To our knowledge, this is the first case series to report on a modified implantation technique of the Perceval prosthesis. The Perceval valve prosthesis produces excellent outcome in most pathologies, so that current contraindications should be revised.

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Novel Treatment of a Degenerated Bioroot With the Use of the Sutureless Valve Technique

Cited by 5 publications

References 6 publications

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients

Outcome of a Modified Perceval Implantation Technique

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