• Joseph F Sabik, Vivek Rao, Rüdiger Lange, A Pieter Kappetein, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Neil J Weissman, Himanshu J Patel, Michael J Reardon, Federico M Asch, Cathy Zeng, Klautz Robert J M RJM Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands., and PERIGON Investigators.
• Department of Surgery, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio. Electronic address: Joseph.Sabik@UHHospitals.org.
• J. Thorac. Cardiovasc. Surg. 2018 Oct 1; 156 (4): 1368-1377.e5.

ObjectivesThe study objectives were to evaluate the safety, effectiveness, and hemodynamic performance of a new stented bovine pericardial aortic valve.MethodsThis trial enrolled patients with symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. We assessed death, valve-related adverse events, functional recovery, and hemodynamic performance at discharge, 3 to 6 months, and 1 year, as required by the US Food and Drug Administration for regulatory approval. The primary analysis compared late linearized rates of valve-related adverse events after implantation with Food and Drug Administration-specified objective performance criteria to determine whether the adverse event rates associated with the valve are within acceptable limits. Adverse events included thromboembolism, thrombosis, all and major hemorrhage, all and major paravalvular leak, and endocarditis.ResultsThe primary analysis included 864 patients who received an implant and 904.1 valve-years of follow-up. A total of 577 patients completed the 1-year evaluation. The primary end point was met for death, thromboembolism, thrombosis, all and major paravalvular leak, and endocarditis, but not for all and major hemorrhage. At 1 year, freedom from all death and from valve-related death was 96.4% and 99.7%, respectively. From baseline to 1 year, New York Heart Association class changed as follows: I, 10.8% to 73.7%; II, 48.9% to 22.6%; III, 38.0% to 3.5%; and IV, 2.3% to 0.2%. Effective orifice area increased from 0.9 ± 0.5 to 1.5 ± 0.4 (P < .0001), and mean aortic gradient decreased from 42.7 ± 16.5 to 12.5 ± 4.3 (P < .0001).ConclusionsThis analysis of a new stented bovine pericardial aortic valve demonstrated low overall mortality and valve-related adverse events, and hemodynamic performance comparable to that of other surgical aortic valves.Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

3 keywords...

hide…