ArticleInteractive cardiovascular and thoracic surgery2022
Avoiding oversizing in sutureless valves leads to lower transvalvular gradients and less permanent pacemaker implants postoperatively.
Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Use of Perceval Valves in Older Patients: A Systematic Review.Reviews in cardiovascular medicine · 2025Pooled it
- A Word of Caution: Aorto-Right Ventricular Fistula, an Uncommon Pitfall of Perceval Sutureless Valve.Journal of cardiovascular development and disease · 2026Article
- Current Landscape in the Management of Aortic Stenosis.Journal of clinical medicine · 2025Review
- Long-term outcomes of the largest (29) Epic Supra aortic valve bioprosthesis: comparing recommended with upsizing implantation.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Predictors of the Need for Permanent Pacemaker Implantation After Surgical Aortic Valve Replacement with a Biological Prosthesis and the Effect on Long-Term Survival.Journal of cardiovascular development and disease · 2024Article
- Early outcomes of aortic valve replacement with Perceval PLUS sutureless valve: results of the prospective multicentric MANTRA study.Journal of cardiothoracic surgery · 2024Article
- Single-Center Real-World Experience with Sutureless Aortic Valve Prosthesis in Isolated and Combined Procedures.Journal of clinical medicine · 2023Article
- Sutureless Aortic Valve Prosthesis in Redo Procedures: Single-Center Experience.Medicina (Kaunas, Lithuania) · 2023Article
- Clinical and hemodynamic outcomes of the Perceval sutureless aortic valve from a real-world registry.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- A comparative study of minimally invasive aortic valve replacement with sutureless biological versus mechanical prostheses.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2023Article
- Sutureless aortic valve replacement: the importance of sizing.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Rapid-Deployment Aortic Valve Replacement: Patient Selection and Special Considerations.Vascular health and risk management · 2023Review
- The importance of sizing in sutureless valves.Interactive cardiovascular and thoracic surgery · 2022Article
- The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology.Innovations (Philadelphia, Pa.)Review
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to evaluate the impact of changing the sizing strategy in aortic valve replacement using the Perceval sutureless prosthesis on haemodynamic outcomes and postoperative pacemaker implantation.
methodsRetrospective analysis of patients implanted with the Perceval valve between 2007 and 2019 was performed by comparing patients implanted before the modification of sizing strategy (OLD group) and after (NEW group). The outcome parameters evaluated were the implanted prosthesis size, haemodynamical profile and postoperative pacemaker implantation.
resultsThe entire patient cohort (784 patients) consisted of 52% female patients, with a mean age of 78.53 [standard deviation (SD): 5.8] years and a mean EuroSCORE II of 6.3 (range 0.7-76). In 55.5% of cases, surgery was combined. The NEW cohort had more male patients (54.6% vs 43.4%) (P = 0.002). Mean implanted valve size, corrected for body surface area, was significantly lower in the NEW cohort (13.1, SD: 1.4 vs 13.5, SD: 1.4 mm/m2, P < 0.001). The 30-day mortality was 3.4%. Peak and mean transvalvular gradients at discharge were significantly lower in the NEW versus OLD groups: 24.4 mmHg (SD: 9.2) versus 28.4 mmHg (SD: 10.3) (P < 0.001) and 13.6 mmHg (SD: 5.3) versus 15.5 mmHg (SD: 6.0) (P < 0.001). The mean effective opening area and the indexed effective opening area, respectively, increased from 1.5 cm2 (SD: 0.5) and 0.85 cm2/m2 (SD: 0.27) in the OLD group to 1.7 cm2 (SD: 0.5) and 0.93 cm2/m2 (SD: 0.30) in the NEW group (P < 0.001). No difference was found in paravalvular leakage ≥1/4. Centrovalvular leakage ≥1/4 significantly decreased from 18% to 7.9% (P < 0.001). With the new sizing, the new postoperative pacemaker implantation rate decreased significantly from 11% to 6.1% (P = 0.016).
conclusionsCorrect sizing of sutureless aortic valves is crucial to obtain the best possible haemodynamics and avoid complications.
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