Medium-Term Outcomes of Perceval Sutureless Aortic Valve Replacement in Aotearoa New Zealand

BACKGROUND: The Perceval bioprosthesis is a contemporary sutureless technology utilised for surgical aortic valve replacement (AVR). Perceval valves allow for AVR with reduced cross-clamp and cardiopulmonary bypass times, which correlates with improved postoperative patient morbidity and mortality. However, there is a paucity of literature reporting the medium-term outcomes from Perceval AVR in New Zealand. We aimed to investigate the mid-term outcomes from Perceval AVR at our single centre. METHOD: All consecutive patients undergoing Perceval AVR (during isolated or combined procedures) at our unit from March 2011 to August 2021 were retrospectively analysed from a prospectively-collected database. RESULTS: Across the 10-year study period, 145 patients (mean age: 73.2 years; males: 71.7%; mean EuroSCORE II: 3.78%) underwent Perceval AVR. The most common indication for surgery was aortic stenosis (82.5%). The operative caseload was complex, with only 27.6% of patients undergoing first-time isolated AVR. The mean crossclamp and cardiopulmonary bypass times were 74.7±40.6 and 111.3±63.6 minutes respectively. Latest follow-up transthoracic echocardiography (performed at a mean of 2.2±1.7 years postoperatively) revealed that 96% of patients had either none or only trivial paravalvular/transvalvular leaks. The 30-day mortality and stroke rates were 6.2% and 2.1% respectively. Medium-term survival rates across 5-year and 9.5-year follow-up were 70% and 55% respectively. There was only one reoperation on the aortic valve. CONCLUSIONS: Across an older patient population undergoing complex cardiac surgery, Perceval AVR facilitates acceptable short-term and medium-term outcomes in terms of both prosthetic valvular function and survival.