Long-term Outcomes of Patients Undergoing Aortic Valve Replacement with the Perceval Sorin S Valve: A Propensity-matched Case-control Study
Dr. Thomas French1, Mr Sanjeet Singh1, Mr Vipin Zamvar1
1Department of Cardiology and Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Objective
The Perceval Sorin S is a rapid-deployment sutureless bioprosthetic designed for use in a high-risk cohort who might be unsuitable for TAVI or traditional AVR. We compared immediate post-operative outcomes and long-term mortality in a cohort undergoing isolated AVR with the Perceval Sorin S to a comparable cohort undergoing surgical AVR with a sutured bioprosthesis.
Methods
This study was designed as a retrospective, single-centre case-control study using data from our hospital’s national audit database. Between the years 2017 and 2023, 943 suitable patients were identified. 178 perceval valve replacements were matched to 178 sutured valve replacements. Baseline cohort characteristics, intra-operative details and post-operative outcomes were compared between the two groups. Time-to-event analysis was used to compare cumulative four-year survival between the two groups.
Results
Time under aortic cross-clamping (p<0.001), time under cardiopulmonary bypass (p<0.001) and total intra-operative time (p<0.001) were reduced in the perceval group. Patients in the perceval valve group were at a lower risk of post-operative pneumonia (OR: 0.52 (0.32-0.85)) and atrial fibrillation (OR: 0.47 (0.26-0.83)). After propensity-matching, all-cause mortality did not significantly differ between the two groups in the 4-year follow-up period.
Conclusions
Perceval valve AVR is a safe and efficient alternative to AVR with a sutured bioprosthesis. Less time on the cardiopulmonary bypass circuit allows for treatment of otherwise high-risk patients. The high rates of stroke and complete heart block observed in cohorts with similar valve design -such as those used in TAVI procedures – were not observed in this cohort.