Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment

Augusto D'Onofrio, Stefano Salizzoni, Claudia Filippini, Chiara Tessari, Lorenzo Bagozzi, Antonio Messina, Giovanni Troise, Margerita Dalla Tomba, Manfredo Rambaldini, Magnus Dalén, Francesco Alamanni, Massimo Massetti, Carmelo Mignosa, Claudio Russo, Loris Salvador, Roberto Di Bartolomeo, Daniele Maselli, Ruggero De Paulis, Ottavio Alfieri, Carlo Maria De FilippoMichele Portoghese, Uberto Bortolotti, Mauro Rinaldi, Gino Gerosa

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of this retrospective multicenter study was to compare early clinical and hemodynamic outcomes of Perceval-S sutureless (Livanova, London, United Kingdom) and Intuity rapid-deployment (Edwards Lifesciences, Irvine, Calif) bioprostheses.

METHODS: Data from patients who underwent isolated or combined aortic valve replacement with Perceval-S and with Intuity bioprostheses at 18 cardiac surgical institutions were analyzed. Propensity matching was performed to identify similar patient cohorts.

RESULTS: We included 911 patients from March 2011 until May 2017. Perceval-S and Intuity valves were implanted in 349 (38.3%) and in 562 (61.7%) patients, respectively. Propensity score identified 117 matched pairs. In the matched cohort, device success was 99.1% and 100% in Perceval-S and Intuity group, respectively (P = 1.000). Thirty-day Valve Academic Research Consortium mortality occurred in 2 (1.7%) and 4 (3.4%) patients in the Perceval-S and in Intuity group, respectively (P = .6834). The rate of postoperative new permanent pacemaker implantation was 6% (7 patients) and 6.8% (8 patients) in the Perceval-S and in Intuity group, respectively (P = .7896). Perceval-S valve implantation requires significantly shorter aortic crossclamp and cardiopulmonary bypass times than Intuity valve implantation (aortic crossclamp time for isolated, 52 ± 14 minutes vs 62 ± 24 minutes; P < .0001). Peak transaortic gradients were 22.4 ± 8.1 mm Hg and 19.6 ± 6.7 mm Hg (P = .0144), whereas mean gradients were 11.8 ± 4.7 mm Hg and 10.5 ± 3.9 mm Hg (P = .0388) in the Perceval-S and Intuity groups, respectively.

CONCLUSIONS: Sutureless Perceval-S and rapid-deployment Intuity bioprostheses provide good and similar early clinical and hemodynamic outcomes. Perceval-S valve implantation requires shorter crossclamp and cardiopulmonary bypass times, whereas Intuity valve implantation provides lower transaortic peak and mean gradients.

Original languageEnglish
JournalJournal of Thoracic and Cardiovascular Surgery
DOIs
Publication statusE-pub ahead of print - May 11 2019

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  • Cite this

    D'Onofrio, A., Salizzoni, S., Filippini, C., Tessari, C., Bagozzi, L., Messina, A., Troise, G., Tomba, M. D., Rambaldini, M., Dalén, M., Alamanni, F., Massetti, M., Mignosa, C., Russo, C., Salvador, L., Di Bartolomeo, R., Maselli, D., De Paulis, R., Alfieri, O., ... Gerosa, G. (2019). Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment. Journal of Thoracic and Cardiovascular Surgery. https://doi.org/10.1016/j.jtcvs.2019.02.135