• J. Thorac. Cardiovasc. Surg. · Feb 2020

    Multicenter Study

    Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment.

    • Augusto D'Onofrio, Stefano Salizzoni, Claudia Filippini, Chiara Tessari, Lorenzo Bagozzi, Antonio Messina, Giovanni Troise, Margerita Dalla Tomba, Manfredo Rambaldini, Magnus Dalén, Francesco Alamanni, Massimo Massetti, Carmelo Mignosa, Claudio Russo, Loris Salvador, Roberto Di Bartolomeo, Daniele Maselli, Ruggero De Paulis, Ottavio Alfieri, Carlo Maria De Filippo, Michele Portoghese, Uberto Bortolotti, Mauro Rinaldi, and Gino Gerosa.
    • Division of Cardiac Surgery, Azienda Ospedaliera/University of Padua, Padua, Italy. Electronic address: adonofrio@hotmail.it.
    • J. Thorac. Cardiovasc. Surg. 2020 Feb 1; 159 (2): 432-442.e1.

    ObjectivesThe aim of this retrospective multicenter study was to compare early clinical and hemodynamic outcomes of Perceval-S sutureless (Livanova, London, United Kingdom) and Intuity rapid-deployment (Edwards Lifesciences, Irvine, Calif) bioprostheses.MethodsData from patients who underwent isolated or combined aortic valve replacement with Perceval-S and with Intuity bioprostheses at 18 cardiac surgical institutions were analyzed. Propensity matching was performed to identify similar patient cohorts.ResultsWe included 911 patients from March 2011 until May 2017. Perceval-S and Intuity valves were implanted in 349 (38.3%) and in 562 (61.7%) patients, respectively. Propensity score identified 117 matched pairs. In the matched cohort, device success was 99.1% and 100% in Perceval-S and Intuity group, respectively (P = 1.000). Thirty-day Valve Academic Research Consortium mortality occurred in 2 (1.7%) and 4 (3.4%) patients in the Perceval-S and in Intuity group, respectively (P = .6834). The rate of postoperative new permanent pacemaker implantation was 6% (7 patients) and 6.8% (8 patients) in the Perceval-S and in Intuity group, respectively (P = .7896). Perceval-S valve implantation requires significantly shorter aortic crossclamp and cardiopulmonary bypass times than Intuity valve implantation (aortic crossclamp time for isolated, 52 ± 14 minutes vs 62 ± 24 minutes; P < .0001). Peak transaortic gradients were 22.4 ± 8.1 mm Hg and 19.6 ± 6.7 mm Hg (P = .0144), whereas mean gradients were 11.8 ± 4.7 mm Hg and 10.5 ± 3.9 mm Hg (P = .0388) in the Perceval-S and Intuity groups, respectively.ConclusionsSutureless Perceval-S and rapid-deployment Intuity bioprostheses provide good and similar early clinical and hemodynamic outcomes. Perceval-S valve implantation requires shorter crossclamp and cardiopulmonary bypass times, whereas Intuity valve implantation provides lower transaortic peak and mean gradients.Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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