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Clinical and Hemodynamic Outcomes in 121 Patients Who Underwent Perceval Sutureless Aortic Valve Implantation - Early Results From a Single Korean Institution

Authors
 Do Jung Kim  ;  Sak Lee  ;  Hyun-Chel Joo  ;  Young-Nam Youn  ;  Kyung-Jong Yoo  ;  Seung Hyun Lee 
Citation
 CIRCULATION JOURNAL, Vol.85(7) : 1011-1017, 2021-06 
Journal Title
CIRCULATION JOURNAL
ISSN
 1346-9843 
Issue Date
2021-06
Keywords
Aortic valve ; Pacemaker implantation ; Perceval valve ; Sutureless aortic valve replacement
Abstract
Background: This study aimed to evaluate the early outcomes of Perceval sutureless valves in the Korean population and to introduce a modified technique of guiding suture placement during valve deployment.Methods and Results:From December 2014 to April 2019, 121 patients (mean age: 74.7±6.2 years; 53.7% female) received a Perceval sutureless aortic valve replacement. To prevent conduction system injury, the depth of guiding suture placement (1 mm below the nadir of the annulus) was modified. All patients underwent echocardiographic evaluation at discharge and 6-12 months postoperatively, with a mean follow up of 13.7±11.2 months. Concomitant surgeries, such as coronary artery bypass grafting, and other valvular surgeries, were performed in 45.5% of cases. The mean aortic cross-clamp times for isolated and minimal procedures were 32.8±7.9, and 41.2±8.0 min, respectively. The overall transvalvular mean gradients were 13.1±3.8 mmHg at discharge and 11.5±4.7 mmHg at the last follow up. After modifying the guiding suture placement, permanent pacemaker implantation risk decreased from 9.9% to 2.5%. Cardiac-related mortality was 0.8%, with no patient developing valvular or paravalvular aortic regurgitation, valve thrombosis, or endocarditis.

Conclusions: Perceval valve implantation provided a significant cardiac-related survival benefit with excellent early hemodynamic and clinical outcomes. Further research is needed to determine whether adjusting the implantation depth, such as modification of the guiding suture technique, can reduce the risk of permanent pacemaker implantation.
Files in This Item:
T202104828.pdf Download
DOI
10.1253/circj.CJ-21-0023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Youn, Young Nam(윤영남)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Lee, Seung Hyun(이승현) ORCID logo https://orcid.org/0000-0002-0311-6565
Joo, Hyun Chel(주현철) ORCID logo https://orcid.org/0000-0002-6842-2942
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186926
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