Cardiopulmonary Bypass and Cross-Clamping Times in Aortic Valve Replacement Surgery by Ministernotomy with Sutureless Prosthesis Implantation Compared to Conventional Prosthesis: A Cross-Sectional Study.

Abstract

Introduction: Valve replacement is one of the effective treatments for aortic valve disease. This study aims to compare cardiopulmonary bypass and ischemia times in aortic valve replacement surgeries using stented biological and sutureless prostheses (PERCEVAL®) through a minimally invasive ministernotomy approach. Methods: This single-center cross-sectional study, conducted from February 2015 to February 2021, assessed clinical and epidemiological characteristics in aortic valve replacement patients. It analyzed factors including hospital stay, early outcomes, valve etiology, intraoperative diagnosis, systolic gradients, left ventricular ejection fraction, and left ventricular mass. Two groups were studied: 12 patients with PERCEVAL® prostheses and 81 with conventional bioprostheses.

Results: This study included 93 patients (age: 59 ± 16 years), 61.3% were male, and 80.2% had hypertension; dyslipidemias were present in 34.1% and 25.3% were diabetic. Cardiopulmonary bypass and cross-clamping times were 61 minutes and 41 minutes in the conventional bioprostheses group and 59.5 minutes and 39.5 minutes in the PERCEVAL® group (P=0.143 and P=0.058, respectively). Intensive care unit and overall hospital stays were statistically comparable between both groups (P=0.662 and P=0.599, respectively). All participants survived the 30-day postoperative period, with minimal complications, no significant differences in echocardiographic parameters were observed, yet higher values for certain cardiac function indicators were noted in the conventional bioprostheses group.

Conclusion: The groups with conventional bioprostheses and sutureless prostheses (PERCEVAL®) didn't display significant differences in the analyzed variables for ministernotomy aortic valve replacement surgery. They exhibited similar results in terms of hospital stay duration, 30-day outcomes, and cardiac function values.