Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series
Abstract Background The Perceval Sutureless prosthesis can increase the effective orifice area (EOA) and reduce the chance of prosthesis–patient mismatch (PPM). This report presents three patients with challenging degenerated bioprosthetic valves undergoing redo aortic valve replacement (rAVR) using...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-025-03369-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849331652034035712 |
|---|---|
| author | Pouya Nezafati Chimezi Uchime Sumit Yadav |
| author_facet | Pouya Nezafati Chimezi Uchime Sumit Yadav |
| author_sort | Pouya Nezafati |
| collection | DOAJ |
| description | Abstract Background The Perceval Sutureless prosthesis can increase the effective orifice area (EOA) and reduce the chance of prosthesis–patient mismatch (PPM). This report presents three patients with challenging degenerated bioprosthetic valves undergoing redo aortic valve replacement (rAVR) using the Perceval (LivaNova, London, UK) prosthesis from a cohort of more than 300 performed cases and a review of the literature on the management of challenging degenerated valves. Methods Case 1: Degenerated 23 mm Trifecta with the valve cage densely adherent to the annulus. Cage with sewing ring were excised and annulus sized to a large Perceval valve. Case 2: Degenerated 29 mm Epic from a Bentall’s procedure. Calcified and rigid prosthetic leaflets as well as stent posts were excised and XL Perceval implanted. Case 3: Degenerated 27 mm Epic with signs of endocarditis from a history of Bentall’s procedure. Three calcified leaflets of the Epic valve were completely excised. The orifice accepted a medium Perceval. Results The total Cardiopulmonary Bypass (CPB) and aortic cross clamp (ACC) times (in minutes) were 99.76, 117.68 and 143.99 in Cases 1, 2 and 3, respectively. Moreover, post-implantation transesophageal echocardiogram (TOE) demonstrated a well-seated valve, no paravalvular leak in all cases and a peak gradient of 12.7 mmHg, 14.8 mmHg and 17.7 mmHg in Cases 1, 2 and 3, respectively. Conclusion The Perceval prosthesis is an excellent choice for rAVR, as it can safely simplify challenging cases at risk of PPM and is an excellent valve-in-valve alternative to degenerated or infected Bentall valves with patent graft. The Perceval prosthesis can be well seated on the different structures of a degenerated bioprosthetic valve. |
| format | Article |
| id | doaj-art-92e7f3e11c4d4781bdae8e148aeb5bcc |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-92e7f3e11c4d4781bdae8e148aeb5bcc2025-08-20T03:46:27ZengBMCJournal of Cardiothoracic Surgery1749-80902025-08-012011610.1186/s13019-025-03369-yPerceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case seriesPouya Nezafati0Chimezi Uchime1Sumit Yadav2Department of Cardiothoracic Surgery, Liverpool Hospital, New South Wales HealthDepartment of Cardiothoracic Surgery, Townsville University Hospital, Queensland HealthDepartment of Cardiothoracic Surgery, Townsville University Hospital, Queensland HealthAbstract Background The Perceval Sutureless prosthesis can increase the effective orifice area (EOA) and reduce the chance of prosthesis–patient mismatch (PPM). This report presents three patients with challenging degenerated bioprosthetic valves undergoing redo aortic valve replacement (rAVR) using the Perceval (LivaNova, London, UK) prosthesis from a cohort of more than 300 performed cases and a review of the literature on the management of challenging degenerated valves. Methods Case 1: Degenerated 23 mm Trifecta with the valve cage densely adherent to the annulus. Cage with sewing ring were excised and annulus sized to a large Perceval valve. Case 2: Degenerated 29 mm Epic from a Bentall’s procedure. Calcified and rigid prosthetic leaflets as well as stent posts were excised and XL Perceval implanted. Case 3: Degenerated 27 mm Epic with signs of endocarditis from a history of Bentall’s procedure. Three calcified leaflets of the Epic valve were completely excised. The orifice accepted a medium Perceval. Results The total Cardiopulmonary Bypass (CPB) and aortic cross clamp (ACC) times (in minutes) were 99.76, 117.68 and 143.99 in Cases 1, 2 and 3, respectively. Moreover, post-implantation transesophageal echocardiogram (TOE) demonstrated a well-seated valve, no paravalvular leak in all cases and a peak gradient of 12.7 mmHg, 14.8 mmHg and 17.7 mmHg in Cases 1, 2 and 3, respectively. Conclusion The Perceval prosthesis is an excellent choice for rAVR, as it can safely simplify challenging cases at risk of PPM and is an excellent valve-in-valve alternative to degenerated or infected Bentall valves with patent graft. The Perceval prosthesis can be well seated on the different structures of a degenerated bioprosthetic valve.https://doi.org/10.1186/s13019-025-03369-yPercevalDegenerated aortic valveAortic valve replacement |
| spellingShingle | Pouya Nezafati Chimezi Uchime Sumit Yadav Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series Journal of Cardiothoracic Surgery Perceval Degenerated aortic valve Aortic valve replacement |
| title | Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series |
| title_full | Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series |
| title_fullStr | Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series |
| title_full_unstemmed | Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series |
| title_short | Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series |
| title_sort | perceval prosthesis implantation into challenging degenerated aortic valves a literature review and case series |
| topic | Perceval Degenerated aortic valve Aortic valve replacement |
| url | https://doi.org/10.1186/s13019-025-03369-y |
| work_keys_str_mv | AT pouyanezafati percevalprosthesisimplantationintochallengingdegeneratedaorticvalvesaliteraturereviewandcaseseries AT chimeziuchime percevalprosthesisimplantationintochallengingdegeneratedaorticvalvesaliteraturereviewandcaseseries AT sumityadav percevalprosthesisimplantationintochallengingdegeneratedaorticvalvesaliteraturereviewandcaseseries |