Novel Perceval Sizing Technique: Single Center Experience

Abstract

Objective Aim of this study was to compare old (manufacturer recommended) and new (institution based) sizing techniques for sutureless valve. Materials A 226 consecutively operated patients underwent aortic valve replacement with Perceval sutureless valve (Corcym) and had CT scan with contrast enhancement were included to this study. The final decision of appropriate size is based on intra-operative obturator sizing. Briefly, we have measured on the CT scans the annular ring surface and perimeter in order to estimate the prosthesis size. New sizing technique uses only white obturator of Perceval and it should passe trough the annulus with slight friction, which practically under-sizes with respect to manufacturer's recommendations. Results The operative mortality was 1 (0.44 %). There were no prosthesis migration neither annular rupture in any group. The mean follow up was lower in new group (3.3 ± 2.0 vs 9.7 ± 1.6, p < 0.01). At the discharge the patients who have used the new sizing technique had less gradient on the prosthetic valve (13.4 ± 5.0 vs 15.2 ± 5.5, p = 0.02). The new sizing was less prone to degeneration at the follow-up which would require intervention (13.4 ± 5.0 vs 15.2 ± 5.5, p = 0.02). Oversizing of 22.6% had significant role on valve gradient increase and structural degeneration (p < 0.05). Conclusions New sizing technique is safe and reproducible. It seem to deliver better immediate and long term benefits for Perceval sutureless valve, less postoperative gradient, less probability or structural degeneration.