Perceval Less Invasive Aortic Replacement Register: multicentric Spanish experience with the Perceval S bioprosthesis in moderate-high-risk aortic surgery.

Autor:	Berastegui García E; Department of Cardiac Surgery, Hospital Germans Trias i Pujol, Badalona, Spain., Camara Rosell ML; Department of Cardiac Surgery, Hospital Germans Trias i Pujol, Badalona, Spain., Estevez Cid F; Department of Cardiac Surgery, Complejo Hospitalario Universitario A Coruña, CHUAC, A Coruña, Spain., Sanchez Dominguez E; Department of Cardiac Surgery, Hospital Infanta Cristina - Badajoz, Badajoz, Spain., Rios Barrera R; Department of Cardiac Surgery, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Sbraga F; Department of Cardiac Surgery, Hospital Universitari Bellvitge, Hospitalet de Llobregat, Spain., Garcia Puente J; Department of Cardiac Surgery, Hospital Universitario Virgen de la Arraixaca, Murcia, Spain., Rosello Diez E; Department of Cardiac Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Cuerpo Caballero GP; Department of Cardiac Surgery, Hospital Universitario Gregorio Marañon, Madrid, Spain., Bustamante Munguira J; Department of Cardiac Surgery, Hospital Germans Trias i Pujol, Badalona, Spain.; Department of Cardiac Surgery, Hospital Universitario La Princesa, Madrid, Spain., Reyes Copa G; Department of Cardiac Surgery, Hospital Universitario La Princesa, Madrid, Spain., Tena Pajuelo M; Department of Cardiac Surgery, Hospital Universitario Dr. Negrin, Las Palmas, Spain., Serrano Fiz S; Department of Cardiac Surgery, Hospital Universitario Puerta de Hierro, Madrid, Spain., Buendía Miñano JA; Department of Cardiac Surgery, Hospital Universitario Virgen de la Salud - Toledo, Toledo, Spain., García Martin I; Department of Cardiac Surgery, Hospital Universitario Marques de Valdecilla (HUMV), Santander, Spain., Cuenca Castillo J; Department of Cardiac Surgery, Complejo Hospitalario Universitario A Coruña, CHUAC, A Coruña, Spain., Cánovas Lopez S; Department of Cardiac Surgery, Hospital Universitario Virgen de la Arraixaca, Murcia, Spain., Gonzalez Pinto A; Department of Cardiac Surgery, Hospital Universitario Gregorio Marañon, Madrid, Spain., Ruyra Baliarda X; Department of Cardiac Surgery, Hospital Germans Trias i Pujol, Badalona, Spain.
Jazyk:	angličtina
Zdroj:	Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2018 Apr 01; Vol. 26 (4), pp. 596-601.
DOI:	10.1093/icvts/ivx384
Abstrakt:	Objectives: The development of new percutaneous and surgical techniques has reduced the risk associated with aortic valve replacement procedures. We present the results of a Spanish register after initiating a programme for sutureless prostheses in moderate-high-risk patients. Methods: This prospective multicentre study was carried out from November 2013 to November 2016. Data were obtained from 448 patients in whom a Perceval S prosthesis was implanted. Results: The mean age was 79.24 (standard deviation [SD] 4.1) years, and 61.2% were women. The estimated EuroSCORE I log risk was 11.15% (SD 7.6), with an observed mortality of 4.4% (20 patients). Isolated aortic valve replacement was performed on 69.26% of patients, with 64% involving ministernotomy. The incidence of neurological events was 2%, with 2 permanent cerebrovascular accidents, and 41 (9.2%) patients were implanted with a permanent endocavitary pacemaker. At discharge, 12 (2.6%) patients presented minimal periprosthetic leakage, and 4 (0.89%) patients had moderate leakage. There were 3 reinterventions during follow-up (2 endocarditis and 1 dysfunction due to periprosthetic leak progression). The mean gradient at discharge, 6 months and 1 year was 12.94 (SD 5.3) mmHg, 12.19 (SD 4.7) mmHg and 11.77 (SD 4.7) mmHg, respectively; 59.4% of the patients were octogenarians, with a survival rate of 98% at both 6 months and 1 year at discharge. There was neither valve migration nor early structural degeneration. The mean follow-up was 12 ± 3 months. The 6-month and 1-year mortality was 1.4% and 2.1%, respectively. Conclusions: This is a prospective multicentric study on the largest cohort of patients with sutureless valves conducted in Spain to date. It is a reproducible procedure that has enabled surgery on patients with a moderate-high risk with low morbidity and mortality, providing good haemodynamic results.
Databáze:	MEDLINE
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