The Superiority Of Conventional Valves Over Sutureless Alternatives: An In-depth Study Comparing Dokimos To The Perceval Bioprosthesis
ALI ALJALLOUD, MD, Rüdiger Autschbach, MD, Konstantina Spetsotaki, MD.
RWTH University Hospital Aachen, Aachen, Germany.
OBJECTIVE:This comparative study between the sutureless Perceval prosthesis (Corcym Srl, Milan, Italy) and Labcor Dokimos Plus (LDP) aortic bioprosthesis aimed to identify the potential advantages of sutureless aortic valve replacements through a closer examination of the supposed benefits, which include shortened cross-clamp and implantation time as well as the overall safety and the clinical outcome.
METHODS:Between August 2014 and May 2019, a total of 279 patients (69% female) with a mean age of 78 years underwent surgical aortic valve replacement (SAVR) receiving either Perceval or Dokimus bioprostheses in our Department of Cardiac Surgery at the RWTH Aachen University Hospital. Retrospective analysis was undertaken of patients who received one of the two bioprotheses: Perceval or Dokimos. 141 patients received Perceval while 138 received the Dokimus heart valve bioprosthesis. The two groups were matched taking the following into consideration: age, STS score, gender and BMI. The primary endpoints included clinical outcomes and complication rates during the early postoperative period.
CONCLUSIONS:Our findings suggest that there are no clear advantages for implantingthe sutureless valve Perceval in terms of shortened cross-clamp time, overall safety, and the clinical outcome of the patients. Moreover, the hemodynamic performance of the conventional valve proved to be superior to its sutureless counterpart as evidenced by transvalvular gradients, AVAI, LDH and thrombocytopenia levels.
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