Abstract 16702: Does Perceval Sutureless Aortic Valve Offer Advantages Over Traditional Surgical Aortic Valve Replacement?

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A16702-A16702
• Main Authors: Robich, Michael P, Gelb, Daniel J, Quinn, Reed D, Robaczewski, David, Radziszewski, Dorothy, Malenka, David J, Ross, Cathy S, Iribarne, Alexander, DiScipio, Anthony W, Kramer, Robert S
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.138.suppl_1.16702

IntroductionThe Perceval S is a sutureless (SLV), rapid deployment, bovine pericardial aortic prosthesis on a nitinol stent. The role of this valve in the age of standard surgical and transcatheter aortic valve replacement is being defined. There are no data on cost from the United States.MethodsWe performed a retrospective review of aortic valve replacement, comparing SLV with traditional sutured AVR (SAVR) at a single center between August 2015 and December 2017. Three surgeons who use both valve types performed 143 SLV and 117 SAVR procedures. Exclusions included mechanical valves, homografts, endocarditis, aortic dissection or emergency status. Hospital cost data (including valve cost) were reviewed. Inverse probability weighting (IPW) was used to balance the groups.ResultsCompared to SAVR, SLV patients were significantly older (Table). Additional procedures (i.e., CABG) were performed with equal frequency. Minimally invasive access was more common for SLV. Cross clamp times were significantly shorter for SLV than SAVR, but were comparable when other procedures were performed. After IPW, groups were well balanced. SLV patients had higher rates of permanent pacemaker placement, pleural effusions and a greater post-procedure drop in platelet counts. There were no differences in rates of postoperative transfusions, atrial fibrillation, stroke, renal failure, prolonged ventilation, length of stay or in-hospital mortality. Hospital costs were comparable. Pacemaker rates for SLV decreased over time (25% in 2015 to 4% in 2017, Ptrend=.003).ConclusionSLVs were selectively used in an older population and were associated with shorter cross clamps times. They were not associated with an increased risk of adverse events other than pacemaker placement, for which there was a learning curve and despite this, their associated cost of care was not significantly great than for SAVR. This valve may be advantageous in older, higher risk patients requiring concomitant operations.