The Percevalreg aortic bio-prosthesis laquo a booster raquo of the mini-invasive

aortic valve replacement programUliegravege experience

Marc A Radermecker R Durieux JP Lavigne V tschana-Sato S Brullsand JO Defraigne

Cardiac anesthetic Team

Cardiac perfusion Team

Surgical aortic valve replacement In the era of TAVI

bull Should have a low morbidity mortality rate

bull Should permit prompt recovery and rehab

bull Should efficiently correct the laquo morphological and dynamic raquo causes of increasedaortic impedance

bull Correct if required dilated ascending aorta pathology

hellip a reproducible easy mini-invasive procedure

bull Features of the Percevalreg auto-expandable self anchoring bio-prosthesis

bull Experience of U liegravege

bull An easy solution to the issue of PPM

bull An easy and laquo teachable raquo mini-invasive approach (proposal)

N Age Gender NYHA Euro-score2

BMI EOA VA junction

SD STJ

115 80 Y 60 M 40F 241 5 2731 73 cm2 226 mm 297 257mm

Mini J conversion CPB CCT Assproc

Perceval Size

Perceval repos

Second run

A-V block Paracentral valv leak

060 1 68rsquo 46rsquo 25 243 6 0 014 001

Re-op mortality PMK implant

Postopregurg

Peak grad

MeanGrad

EOA ICU stay LOS AIAS

0 004 10 008 24 mm Hg

14 mm Hg

173 cm2 3 days 105 days 2

DATA Demographics Pre ndashperoperative and discharge data

Eur J Cardiothorac Surg 2017 Jun 151(6)1093-1099 doi 101093ejctsezx009Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatchdaggerBelluschi I1 Moriggia S1 Giacomini A1 Del Forno B1 Di Sanzo S1 Blasio A1 Scafuri A2 Alfieri O1Author information

AbstractOBJECTIVESThe aim of this study is to compare the theoretical incidence of patient-prosthesismismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matchingMETHODSBetween May 2012 and March 2016 65 patients with severe symptomatic aortic stenosis underwent a suturelessaortic valve replacement with the Perceval bioprosthesis in 2 centres Moreover 177 aortic valve replacements withconventional sutured bioprosthesis were performed between August 2003 and September 2015 Perceval and suturedpatients were 11 exactly matched for sex and body surface area (BSA) resulting in 62 couples (sutureless BSA 177 plusmn016 m 2 female 629 vs sutured BSA 177 plusmn 015 m 2 female 629)RESULTSAfter matching the indexed effective orifice area was 150 plusmn 018thinspcm 2 m 2 and 081 plusmn 019thinspcm 2 m 2 in the suturelessand the sutured group respectively ( P thinspltthinsp0001) No PPM occurred in patients who received a Perceval bioprosthesis ( n thinsp=thinsp62) In the sutured group ( n thinsp=thinsp62) 38 patients (613) developed a PPM which was moderate in 419 ( n thinsp=thinsp26) and severe in 194 ( n thinsp=thinsp12) ( P thinspltthinsp0001)CONCLUSIONSThe indexed effective orifice area of the sutureless group was significantly larger than in the sutured one The incidence of PPM with the conventional sutured biprosthesis was 613 while it decreases to 0 in the sutureless group No PPM was reported in the sutureless valve group Therefore the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reducethe risk of a PPMcopy The Author 2017 Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic

Surgical aortic valve replacement In the era of TAVI

bull Should have a low morbidity mortality rate

bull Should permit prompt recovery and rehab

bull Should efficiently correct the laquo morphological and dynamic raquo causes of increasedaortic impedance

bull Correct if required dilated ascending aorta pathology

hellip a reproducible easy mini-invasive procedure

bull Features of the Percevalreg auto-expandable self anchoring bio-prosthesis

bull Experience of U liegravege

bull An easy solution to the issue of PPM

bull An easy and laquo teachable raquo mini-invasive approach (proposal)

N Age Gender NYHA Euro-score2

BMI EOA VA junction

SD STJ

115 80 Y 60 M 40F 241 5 2731 73 cm2 226 mm 297 257mm

Mini J conversion CPB CCT Assproc

Perceval Size

Perceval repos

Second run

A-V block Paracentral valv leak

060 1 68rsquo 46rsquo 25 243 6 0 014 001

Re-op mortality PMK implant

Postopregurg

Peak grad

MeanGrad

EOA ICU stay LOS AIAS

0 004 10 008 24 mm Hg

14 mm Hg

173 cm2 3 days 105 days 2

DATA Demographics Pre ndashperoperative and discharge data

Eur J Cardiothorac Surg 2017 Jun 151(6)1093-1099 doi 101093ejctsezx009Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatchdaggerBelluschi I1 Moriggia S1 Giacomini A1 Del Forno B1 Di Sanzo S1 Blasio A1 Scafuri A2 Alfieri O1Author information

AbstractOBJECTIVESThe aim of this study is to compare the theoretical incidence of patient-prosthesismismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matchingMETHODSBetween May 2012 and March 2016 65 patients with severe symptomatic aortic stenosis underwent a suturelessaortic valve replacement with the Perceval bioprosthesis in 2 centres Moreover 177 aortic valve replacements withconventional sutured bioprosthesis were performed between August 2003 and September 2015 Perceval and suturedpatients were 11 exactly matched for sex and body surface area (BSA) resulting in 62 couples (sutureless BSA 177 plusmn016 m 2 female 629 vs sutured BSA 177 plusmn 015 m 2 female 629)RESULTSAfter matching the indexed effective orifice area was 150 plusmn 018thinspcm 2 m 2 and 081 plusmn 019thinspcm 2 m 2 in the suturelessand the sutured group respectively ( P thinspltthinsp0001) No PPM occurred in patients who received a Perceval bioprosthesis ( n thinsp=thinsp62) In the sutured group ( n thinsp=thinsp62) 38 patients (613) developed a PPM which was moderate in 419 ( n thinsp=thinsp26) and severe in 194 ( n thinsp=thinsp12) ( P thinspltthinsp0001)CONCLUSIONSThe indexed effective orifice area of the sutureless group was significantly larger than in the sutured one The incidence of PPM with the conventional sutured biprosthesis was 613 while it decreases to 0 in the sutureless group No PPM was reported in the sutureless valve group Therefore the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reducethe risk of a PPMcopy The Author 2017 Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic

hellip a reproducible easy mini-invasive procedure

bull Features of the Percevalreg auto-expandable self anchoring bio-prosthesis

bull Experience of U liegravege

bull An easy solution to the issue of PPM

bull An easy and laquo teachable raquo mini-invasive approach (proposal)

N Age Gender NYHA Euro-score2

BMI EOA VA junction

SD STJ

115 80 Y 60 M 40F 241 5 2731 73 cm2 226 mm 297 257mm

Mini J conversion CPB CCT Assproc

Perceval Size

Perceval repos

Second run

A-V block Paracentral valv leak

060 1 68rsquo 46rsquo 25 243 6 0 014 001

Re-op mortality PMK implant

Postopregurg

Peak grad

MeanGrad

EOA ICU stay LOS AIAS

0 004 10 008 24 mm Hg

14 mm Hg

173 cm2 3 days 105 days 2

DATA Demographics Pre ndashperoperative and discharge data

Eur J Cardiothorac Surg 2017 Jun 151(6)1093-1099 doi 101093ejctsezx009Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatchdaggerBelluschi I1 Moriggia S1 Giacomini A1 Del Forno B1 Di Sanzo S1 Blasio A1 Scafuri A2 Alfieri O1Author information

AbstractOBJECTIVESThe aim of this study is to compare the theoretical incidence of patient-prosthesismismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matchingMETHODSBetween May 2012 and March 2016 65 patients with severe symptomatic aortic stenosis underwent a suturelessaortic valve replacement with the Perceval bioprosthesis in 2 centres Moreover 177 aortic valve replacements withconventional sutured bioprosthesis were performed between August 2003 and September 2015 Perceval and suturedpatients were 11 exactly matched for sex and body surface area (BSA) resulting in 62 couples (sutureless BSA 177 plusmn016 m 2 female 629 vs sutured BSA 177 plusmn 015 m 2 female 629)RESULTSAfter matching the indexed effective orifice area was 150 plusmn 018thinspcm 2 m 2 and 081 plusmn 019thinspcm 2 m 2 in the suturelessand the sutured group respectively ( P thinspltthinsp0001) No PPM occurred in patients who received a Perceval bioprosthesis ( n thinsp=thinsp62) In the sutured group ( n thinsp=thinsp62) 38 patients (613) developed a PPM which was moderate in 419 ( n thinsp=thinsp26) and severe in 194 ( n thinsp=thinsp12) ( P thinspltthinsp0001)CONCLUSIONSThe indexed effective orifice area of the sutureless group was significantly larger than in the sutured one The incidence of PPM with the conventional sutured biprosthesis was 613 while it decreases to 0 in the sutureless group No PPM was reported in the sutureless valve group Therefore the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reducethe risk of a PPMcopy The Author 2017 Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic

N Age Gender NYHA Euro-score2

BMI EOA VA junction

SD STJ

115 80 Y 60 M 40F 241 5 2731 73 cm2 226 mm 297 257mm

Mini J conversion CPB CCT Assproc

Perceval Size

Perceval repos

Second run

A-V block Paracentral valv leak

060 1 68rsquo 46rsquo 25 243 6 0 014 001

Re-op mortality PMK implant

Postopregurg

Peak grad

MeanGrad

EOA ICU stay LOS AIAS

0 004 10 008 24 mm Hg

14 mm Hg

173 cm2 3 days 105 days 2

DATA Demographics Pre ndashperoperative and discharge data

Eur J Cardiothorac Surg 2017 Jun 151(6)1093-1099 doi 101093ejctsezx009Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatchdaggerBelluschi I1 Moriggia S1 Giacomini A1 Del Forno B1 Di Sanzo S1 Blasio A1 Scafuri A2 Alfieri O1Author information

AbstractOBJECTIVESThe aim of this study is to compare the theoretical incidence of patient-prosthesismismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matchingMETHODSBetween May 2012 and March 2016 65 patients with severe symptomatic aortic stenosis underwent a suturelessaortic valve replacement with the Perceval bioprosthesis in 2 centres Moreover 177 aortic valve replacements withconventional sutured bioprosthesis were performed between August 2003 and September 2015 Perceval and suturedpatients were 11 exactly matched for sex and body surface area (BSA) resulting in 62 couples (sutureless BSA 177 plusmn016 m 2 female 629 vs sutured BSA 177 plusmn 015 m 2 female 629)RESULTSAfter matching the indexed effective orifice area was 150 plusmn 018thinspcm 2 m 2 and 081 plusmn 019thinspcm 2 m 2 in the suturelessand the sutured group respectively ( P thinspltthinsp0001) No PPM occurred in patients who received a Perceval bioprosthesis ( n thinsp=thinsp62) In the sutured group ( n thinsp=thinsp62) 38 patients (613) developed a PPM which was moderate in 419 ( n thinsp=thinsp26) and severe in 194 ( n thinsp=thinsp12) ( P thinspltthinsp0001)CONCLUSIONSThe indexed effective orifice area of the sutureless group was significantly larger than in the sutured one The incidence of PPM with the conventional sutured biprosthesis was 613 while it decreases to 0 in the sutureless group No PPM was reported in the sutureless valve group Therefore the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reducethe risk of a PPMcopy The Author 2017 Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic

Eur J Cardiothorac Surg 2017 Jun 151(6)1093-1099 doi 101093ejctsezx009Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatchdaggerBelluschi I1 Moriggia S1 Giacomini A1 Del Forno B1 Di Sanzo S1 Blasio A1 Scafuri A2 Alfieri O1Author information

AbstractOBJECTIVESThe aim of this study is to compare the theoretical incidence of patient-prosthesismismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matchingMETHODSBetween May 2012 and March 2016 65 patients with severe symptomatic aortic stenosis underwent a suturelessaortic valve replacement with the Perceval bioprosthesis in 2 centres Moreover 177 aortic valve replacements withconventional sutured bioprosthesis were performed between August 2003 and September 2015 Perceval and suturedpatients were 11 exactly matched for sex and body surface area (BSA) resulting in 62 couples (sutureless BSA 177 plusmn016 m 2 female 629 vs sutured BSA 177 plusmn 015 m 2 female 629)RESULTSAfter matching the indexed effective orifice area was 150 plusmn 018thinspcm 2 m 2 and 081 plusmn 019thinspcm 2 m 2 in the suturelessand the sutured group respectively ( P thinspltthinsp0001) No PPM occurred in patients who received a Perceval bioprosthesis ( n thinsp=thinsp62) In the sutured group ( n thinsp=thinsp62) 38 patients (613) developed a PPM which was moderate in 419 ( n thinsp=thinsp26) and severe in 194 ( n thinsp=thinsp12) ( P thinspltthinsp0001)CONCLUSIONSThe indexed effective orifice area of the sutureless group was significantly larger than in the sutured one The incidence of PPM with the conventional sutured biprosthesis was 613 while it decreases to 0 in the sutureless group No PPM was reported in the sutureless valve group Therefore the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reducethe risk of a PPMcopy The Author 2017 Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic

Thank you hellip