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Published in: Journal of Cardiothoracic Surgery 1/2023

Open Access 01-12-2023 | Aortic Valve Replacement | Review

Perceval valve intermediate outcomes: a systematic review and meta-analysis at 5-year follow-up

Authors: Jarrod Jolliffe, Simon Moten, Amit Tripathy, Peter Skillington, James Tatoulis, Claudio Muneretto, Lorenzo Di Bacco, Hericka Bruna Figueiredo Galvao, John Goldblatt

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

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Abstract

Objectives

New technologies for the treatment of Aortic Stenosis are evolving to minimize risk and treat an increasingly comorbid population. The Sutureless Perceval Valve is one such alternative. Whilst short-term data is promising, limited mid-term outcomes exist, until now. This is the first systematic review and meta-analysis to evaluate mid-term outcomes in the Perceval Valve in isolation.

Methods

A systematic literature review of 5 databases was performed. Articles included evaluated echocardiographic and mortality outcomes beyond 5 years in patients who had undergone Perceval Valve AVR. Two reviewers extracted and reviewed the articles. Weighted estimates were performed for all post-operative and mid-term data. Aggregated Kaplan Meier curves were reconstructed from digitised images to evaluate long-term survival.

Results

Seven observational studies were identified, with a total number of 3196 patients analysed. 30-day mortality was 2.5%. Aggregated survival at 1, 2, 3, 4 and 5 years was 93.4%, 89.4%, 84.9%, 82% and 79.5% respectively. Permanent pacemaker implantation (7.9%), severe paravalvular leak (1.6%), structural valve deterioration (1.5%), stroke (4.4%), endocarditis (1.6%) and valve explant (2.3%) were acceptable at up to mid-term follow up. Haemodynamics were also acceptable at up mid-term with mean-valve gradient (range 9–13.6 mmHg), peak-valve gradient (17.8–22.3 mmHg) and effective orifice area (1.5–1.8 cm2) across all valve sizes. Cardiopulmonary bypass (78 min) and Aortic cross clamp times (52 min) were also favourable.

Conclusion

To our knowledge, this represents the first meta-analysis to date evaluating mid-term outcomes in the Perceval Valve in isolation and demonstrates good 5-year mortality, haemodynamic and morbidity outcomes.

Key question

What are the mid-term outcomes at up to 5 years follow up in Perceval Valve Aortic Valve Replacement?

Key findings

Perceval Valve AVR achieves 80% freedom from mortality at 5 years with low valve gradients and minimal morbidity.

Key outcomes

Perceval Valve Aortic Valve Replacement has acceptable mid-term mortality, durability and haemodynamic outcomes.
Appendix
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Metadata
Title
Perceval valve intermediate outcomes: a systematic review and meta-analysis at 5-year follow-up
Authors
Jarrod Jolliffe
Simon Moten
Amit Tripathy
Peter Skillington
James Tatoulis
Claudio Muneretto
Lorenzo Di Bacco
Hericka Bruna Figueiredo Galvao
John Goldblatt
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-023-02273-7

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