Title : Sutureless aortic valve replacement
Abstract:
Aortic stenosis is the most common valvular disease and has a poor prognosis without surgical treatment. The use of sutureless valves (SV) has been emerging as a promising surgical option in certain patient populations especially in the elderly, frail and in redo cardiac procedures due to their straightforward and fast deployment technique and the encouraging mid- and long-term outcomes compared to surgical aortic valve replacement (SAVR) with stented valves.
Sutureless and rapid deployment prostheses appeared to provide excellent haemodynamic results together with reduced surgical trauma by facilitating minimally invasive approach. The sutureless surgical approach provides direct visualization of the implantation and target orifice location.
Sutureless aortic valve prostheses provide a safe and feasible treatment option in patients undergoing a combined aortic and mitral valve. Potential advantages for sutureless aortic prostheses include reducing cross-clamp and cardiopulmonary bypass (CPB) duration.
The implantation of a Perceval (LivaNova) sutureless aortic valve is associated with a better postoperative course, as manifested by the lower incidence of postoperative renal failure and blood transfusions.
Furthermore, the use of the Perceval valve allowed for implantation of larger diameter prostheses, resulting in lower transvalvular gradient, and there was no difference in the frequency of postoperative strokes and paravalvular leaks with sutured stented valves.
Therefore Sutureless aortic valve replacement has emerged as a suitable innovative alternative for treatment of aortic stenosis.
The emergence of TAVI (transcatheter aortic valve implantation) for severe aortic valve stenosis and its success has resulted in a drive towards surgical innovation.
