Conventional Prostheses versus Sutureless Perceval for Aortic Valve Replacement: A Meta-Analysis

Annals of Thoracic and Cardiovascular Surgery, vol. 29, pp. 107–124

Abstract

PURPOSE: Perceval sutureless valves have gained popularity. Whether this implant performs superior to the traditional sutured prosthesis remains unclear. This meta- analysis compared the Perceval implants versus the sutured conventional valves for aortic valve replacement (AVR). METHODS: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were accessed: PubMed, Google Scholar, Web of Science, Scopus, and EMBASE. All clinical investigations comparing Perceval versus the conventional prostheses for AVR were considered. RESULTS: The Perceval group demonstrated higher rate of pacemaker implantation (P <0.00001). Aortic cross-clamp (ACC) time (P <0.00001) and cardiopulmonary bypass (CPB) time (P <0.00001) were shorter in the Perceval group. Similarity was found in mean and peak pressure gradient (P = 0.8 and P = 0.2, respectively), mean aortic valve area (P = 0.3), length of intensive care unit (P = 0.4) and hospital stay (P = 0.2), rate of revision (P = 0.11), hemorrhages (P = 0.05), paravalvular leak (P = 0.3), cerebrovascular complication (P = 0.7), and early mortality (P = 0.06). CONCLUSION: Given the shorter ACC time and CPB time, Perceval AVR can be an alternative in high-risk patients. The higher rate of pacemaker implantation following Perceval may limit its routine implantation.

Authors 7

1. Giorgia Colarossi Aachen Department of Thoracic and Cardiovascular Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiology, Rhein Maas Klinikum, Würselen, Germany

   Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany

2. Filippo Migliorini Aachen Department of Orthopaedic, Trauma, and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital Aachen, Aachen, Germany

3. Michael Becker
   Affiliation as printed

   Department of Cardiology, Rhein Maas Klinikum, Würselen, Germany

4. Jessica Paola Arias Aachen Department of Thoracic and Cardiovascular Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany

5. Ruediger Autschbach Aachen Department of Thoracic and Cardiovascular Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany

6. Ajay Kumar Moza Aachen Department of Thoracic and Cardiovascular Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany

7. Ali Aljalloud Aachen Department of Thoracic and Cardiovascular Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiology, Rhein Maas Klinikum, Würselen, Germany

   Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany