Magnus Dalén1, Fausto Biancari2, Antonino S Rubino3, Giuseppe Santarpino4, Herbert De Praetere5, Keiichiro Kasama5, Tatu Juvonen2, Wanda Deste3, Francesco Pollari4, Bart Meuris5, Theodor Fischlein4, Carmelo Mignosa3, Giuseppe Gatti6, Aniello Pappalardo6, Ulrik Sartipy7, Peter Svenarud7. 1. Department of Molecular Medicine and Surgery, Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Electronic address: magnus.dalen@karolinska.se. 2. Department of Surgery, Oulu University Hospital, Oulu, Finland. 3. Cardiac Surgery Unit, Azienda Ospedaliero Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy. 4. Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany. 5. Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium. 6. Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy. 7. Department of Molecular Medicine and Surgery, Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: The aim of this study was to analyze early postoperative outcomes and 2-year survival after aortic valve replacement (AVR) with the sutureless Perceval bioprosthesis (Sorin Biomedica Cardio Srl, Salluggia, Italy) performed through ministernotomy compared with full sternotomy. METHODS: This was a study of 267 consecutive patients who underwent isolated AVR with the sutureless Perceval bioprosthesis between 2007 and 2014 at 6 European centers. Of these, 189 (70.8%) were performed through ministernotomy and 78 through a full sternotomy. Propensity score matching was used to reduce selection bias. RESULTS: In the overall cohort of ministernotomy and full sternotomy patients, in-hospital mortality was 1.1% and 2.6% and 2-year survival was 92% and 91%, respectively. Propensity score matching resulted in 56 pairs with similar characteristics and operative risk. Aortic cross-clamp (44 minutes in both groups, p = 0.931) and cardiopulmonary bypass time (69 vs 74 minutes, p = 0.363) did not differ between the groups. Apart from higher values in the ministernotomy group for postoperative peak gradients (28.1 vs 23.3 mm Hg, p = 0.026) and mean aortic valve gradients (15.2 vs 11.7 mm Hg, p = 0.011), early postoperative outcomes did not differ in the propensity-matched cohort. There were no differences in the in-hospital mortality rate or 2-year survival between the groups. CONCLUSIONS: AVR with the sutureless Perceval bioprosthesis through a ministernotomy was a safe and reproducible procedure that was not associated with prolonged aortic cross-clamp or cardiopulmonary bypass time compared with a full sternotomy. Early postoperative outcomes and 2-year survival were comparable between patients undergoing ministernotomy and full sternotomy.
BACKGROUND: The aim of this study was to analyze early postoperative outcomes and 2-year survival after aortic valve replacement (AVR) with the sutureless Perceval bioprosthesis (Sorin Biomedica Cardio Srl, Salluggia, Italy) performed through ministernotomy compared with full sternotomy. METHODS: This was a study of 267 consecutive patients who underwent isolated AVR with the sutureless Perceval bioprosthesis between 2007 and 2014 at 6 European centers. Of these, 189 (70.8%) were performed through ministernotomy and 78 through a full sternotomy. Propensity score matching was used to reduce selection bias. RESULTS: In the overall cohort of ministernotomy and full sternotomy patients, in-hospital mortality was 1.1% and 2.6% and 2-year survival was 92% and 91%, respectively. Propensity score matching resulted in 56 pairs with similar characteristics and operative risk. Aortic cross-clamp (44 minutes in both groups, p = 0.931) and cardiopulmonary bypass time (69 vs 74 minutes, p = 0.363) did not differ between the groups. Apart from higher values in the ministernotomy group for postoperative peak gradients (28.1 vs 23.3 mm Hg, p = 0.026) and mean aortic valve gradients (15.2 vs 11.7 mm Hg, p = 0.011), early postoperative outcomes did not differ in the propensity-matched cohort. There were no differences in the in-hospital mortality rate or 2-year survival between the groups. CONCLUSIONS: AVR with the sutureless Perceval bioprosthesis through a ministernotomy was a safe and reproducible procedure that was not associated with prolonged aortic cross-clamp or cardiopulmonary bypass time compared with a full sternotomy. Early postoperative outcomes and 2-year survival were comparable between patients undergoing ministernotomy and full sternotomy.
Authors: Michael L Williams; Campbell D Flynn; Andrew A Mamo; David H Tian; Utz Kappert; Manuel Wilbring; Thierry Folliguet; Antonio Fiore; Antonio Miceli; Augusto D'Onofrio; Giorgia Cibin; Gino Gerosa; Mattia Glauber; Theodor Fischlein; Francesco Pollari Journal: Ann Cardiothorac Surg Date: 2020-07
Authors: Kei Woldendorp; Mathew P Doyle; Paul G Bannon; Martin Misfeld; Tristan D Yan; Giuseppe Santarpino; Paolo Berretta; Marco Di Eusanio; Bart Meuris; Alfredo Giuseppe Cerillo; Pierluigi Stefàno; Niccolò Marchionni; Jacqueline K Olive; Tom C Nguyen; Marco Solinas; Giacomo Bianchi Journal: Ann Cardiothorac Surg Date: 2020-09
Authors: Idserd D G Klop; Bart P van Putte; Geoffrey T L Kloppenburg; Mirjam A G Sprangers; Pythia T Nieuwkerk; Patrick Klein Journal: Contemp Clin Trials Commun Date: 2021-01-12
Authors: Mattia Glauber; Simon C Moten; Eugenio Quaini; Marco Solinas; Thierry A Folliguet; Bart Meuris; Antonio Miceli; Peter J Oberwalder; Manfredo Rambaldini; Kevin H T Teoh; Gopal Bhatnagar; Michael A Borger; Denis Bouchard; Olivier Bouchot; Stephen C Clark; Otto E Dapunt; Matteo Ferrarini; Theodor J M Fischlein; Guenther Laufer; Carmelo Mignosa; Russell Millner; Philippe Noirhomme; Steffen Pfeiffer; Xavier Ruyra-Baliarda; Malakh Lal Shrestha; Rakesh M Suri; Giovanni Troise; Borut Gersak Journal: Innovations (Phila) Date: 2016 May-Jun
Authors: Farid Foroutan; Gordon H Guyatt; Kathleen O'Brien; Eva Bain; Madeleine Stein; Sai Bhagra; Daegan Sit; Rakhshan Kamran; Yaping Chang; Tahira Devji; Hassan Mir; Veena Manja; Toni Schofield; Reed A Siemieniuk; Thomas Agoritsas; Rodrigo Bagur; Catherine M Otto; Per O Vandvik Journal: BMJ Date: 2016-09-28
Authors: Francesco Onorati; Riccardo Gherli; Giovanni Mariscalco; Evaldas Girdauskas; Eduardo Quintana; Francesco Santini; Marisa De Feo; Sandro Sponga; Piergiorgio Tozzi; Mohamad Bashir; Andrea Perrotti; Aniello Pappalardo; Vito Giovanni Ruggieri; Giuseppe Santarpino; Mauro Rinaldi; Silva Ronaldo; Francesco Nicolini Journal: BMJ Open Date: 2018-02-10 Impact factor: 2.692