Aortic valve replacement using the Perceval sutureless valve resulted in similar postoperative mortality compared to conventional bioprostheses (2.8% vs 2.7%; OR 0.99; 95% CI 0.52-1.88; P=0.98).
Meta-Analysis (n=1,399)
Does the Perceval sutureless valve improve postoperative and midterm outcomes compared to conventional bioprostheses in patients undergoing isolated aortic valve replacement?
The Perceval sutureless valve offers similar mortality and lower renal failure risk compared to conventional bioprostheses, though at the cost of increased pacemaker implantation.
Odds Ratio: 0.99 (95% CI 0.52–1.88)
Absolute Event Rate: 2.8% vs 2.7%
p-value: p=0.98
Background Aortic stenosis is the most common valvular disease and has a dismal prognosis without surgical treatment. The aim of this meta‐analysis was to quantitatively assess the comparative effectiveness of the Perceval (LivaNova) valve versus conventional aortic bioprostheses. Methods and Results A total of 6 comparative studies were identified, including 639 and 760 patients who underwent, respectively, aortic valve replacement with the Perceval sutureless valve (P group) and with a conventional bioprosthesis (C group). Aortic cross‐clamping and cardiopulmonary bypass duration were significantly lower in the P group. No difference in postoperative mortality was shown for the P and C groups (2.8% versus 2.7%, respectively; odds ratio OR: 0.99 95% confidence interval ( CI ), 0.52–1.88; P =0.98). Incidence of postoperative renal failure was lower in the P group compared with the C group (2.7% versus 5.5%; OR: 0.45 95% CI , 0.25–0.80; P =0.007). Incidence of stroke (2.3% versus 1.7%; OR: 1.34 95% CI , 0.56–3.21; P =0.51) and paravalvular leak (3.1% versus 1.6%; OR : 2.52 95% CI , 0.60–1.06; P =0.21) was similar, whereas P group patients received fewer blood transfusions than C group patients (1.16±1.2 versus 2.13±2.2; mean difference: 0.99 95% CI , −1.22 to −0.75; P =0.001). The incidence of pacemaker implantation was higher in the P than the C group (7.9% versus 3.1%; OR : 2.45 95% CI , 1.44–4.17; P =0.001), whereas hemodynamic Perceval performance was better (transvalvular gradient 23.42±1.73 versus 22.8±1.86; mean difference: 0.90 95% CI , 0.62–1.18; P =0.001), even during follow‐up (10.98±5.7 versus 13.06±6.2; mean difference: −2.08 95% CI , −3.96 to −0.21; P =0.030). We found no difference in 1‐year mortality. Conclusions The Perceval bioprosthesis improves the postoperative course compared with conventional bioprostheses and is an option for high‐risk patients.
Meco et al. (2018) conducted a meta-analysis in Aortic stenosis (n=1,399). Perceval sutureless valve vs. Conventional bioprosthesis was evaluated on Postoperative mortality (OR 0.99, 95% CI 0.52-1.88, p=0.98). Aortic valve replacement using the Perceval sutureless valve resulted in similar postoperative mortality compared to conventional bioprostheses (2.8% vs 2.7%; OR 0.99; 95% CI 0.52-1.88; P=0.98).