Mid-term results of aortic valve surgery in redo scenarios in the current practice: results from the multicentre European RECORD (REdo Cardiac Operation Research Database) initiative†.

Objectives: Although commonly reported as single-centre experiences, redo aortic valve replacement (RAVR) has overall acceptable results. Nevertheless, trans-catheter aortic valve replacement has recently questioned the efficacy of RAVR.

Methods: Early-to-mid-term results and determinants of mortality in 711 cases of RAVR from seven European institutions were assessed in the entire population and in selected high-risk subgroups [elderly >75 years, urgent/emergent procedures, preoperative New York Heart Association (NYHA) functional Class IV and endocarditis].

[Double mitro-aortic valve replacement in a high-risk patient: the sutureless way].

The mitro-aortic disease in high-risk patients is a challenge for the cardiac surgeon because minimally invasive techniques are difficult to apply. We report the first case in the literature of a 78-year-old woman affected by severe rheumatic steno-insufficiency of aortic and mitral valves at high surgical risk. The patient was successfully treated by mitral valve replacement with a biological prosthesis and concomitant aortic valve replacement with a sutureless prosthesis.

Sternal closure following negative pressure wound therapy: a safe approach with a new titanium device.

Background: The application of negative pressure wound therapy (NPWT) in patients with deep wound infection after cardiac surgery has steadily increased worldwide. Following NPWT, in patients with concomitant sternal diastasis, preparation of the substernal structures for the sternal wires application is mandatory, with increased risk of severe complications, such as laceration of the right ventricle. The aim of this study is to present an innovative technique for sternal closure after NPWT, using the ASCS® System (ASCS atraumatic Sternum Closure System; KS Handelsvertretung Produktinovation, Bad Homburg, Germany).

REDO aortic valve replacement: the sutureless approach.

Background And Aim Of The Study: The study aim was to report the results of a single-center cohort of patients who underwent aortic valve replacement (AVR) with a sutureless prosthesis in case of cardiac reoperation (REDO).

Methods: Between March 2010 and December 2011, a total of 83 patients underwent AVR with the Perceval S sutureless aortic bioprosthesis (Sorin Biomedica Cardio Srl, Saluggia, Italy) at the authors' institution. Thirteen of these patients (six males, seven females; mean age 75.

Sutureless replacement versus transcatheter valve implantation in aortic valve stenosis: a propensity-matched analysis of 2 strategies in high-risk patients.

Objective: This propensity-matched study compared clinical and echocardiographic outcomes between patients undergoing transcatheter aortic valve implantation (TAVI) and sutureless aortic valve replacement.

Methods: From January 2010 to March 2012, 122 patients (age 79.4 ± 5.

Advanced age per se should not be an exclusion criterion for minimally invasive aortic valve replacement.

Background And Aim Of The Study: The introduction of transcatheter aortic valve implantation (TAVI), coupled with the increasing number of elderly patients requiring cardiac surgery, has given rise to an intense debate on the most appropriate treatment strategy for this high-risk population. The study aim was to compare clinical outcomes in older versus younger patients undergoing minimally invasive aortic valve replacement (AVR).

Methods: Between March 2010 and July 2012, 66 patients undergoing minimally invasive isolated AVR with the sutureless Perceval S bioprosthesis (Sorin Group, Saluggia, Italy) were allocated to two groups according to age > or = 80 years (group A, n = 25) or < 80 years (group B, n = 41).

Two alternative sutureless strategies for aortic valve replacement: a two-center experience.

Objective: Important comorbid conditions in patients referred for aortic valve replacement (AVR) require less invasive strategies. We describe our initial experience with the Perceval S (Sorin Group, Saluggia, Italy) and 3f Enable (Medtronic, Minneapolis, MN USA) sutureless aortic bioprostheses.

Methods: We compared intraoperative data, postoperative clinical outcomes, and echocardiographic results from patients receiving a Perceval S (P group; n = 97) or a 3f Enable (E group; n = 32) prosthesis in two cardiac surgery departments (Nuremberg, Germany, and Massa, Italy).

Left ventricular mass regression after sutureless implantation of the Perceval S aortic valve bioprosthesis: preliminary results.

Objectives: Left ventricular (LV) hypertrophy in aortic stenosis (AS) is considered a compensatory response helping maintain systolic function, but constitutes a risk factor for cardiac morbidity and mortality. The aim of this study was to assess the degree of LV mass regression after sutureless implantation of the Perceval S aortic valve bioprosthesis (Sorin Group, Saluggia, Italy).

Methods: Between March 2010 and July 2012, 78 patients with symptomatic AS underwent isolated aortic valve replacement (AVR) with the Perceval bioprosthesis.

Outcome of redo surgical aortic valve replacement in patients 80 years and older: results from the Multicenter RECORD Initiative.

Background: Octogenarians undergoing surgical aortic valve replacement (AVR) after prior cardiac surgery are expected to be at high risk of adverse events. This finding has recently popularized transcatheter AVR in this cohort.

Methods: This multicenter study includes 744 patients (99 were 80 years or older) who underwent surgical AVR after prior cardiac surgery.

Minimally invasive aortic valve replacement with Perceval valves: first clinical experience.

Aim: Although minimally invasive aortic valve replacement (MIAVR) has been shown to cause less morbidity than conventional surgery, it has not yet received broad application. The purpose of this study was to evaluate sutureless implantation using the Perceval S aortic valve bioprosthesis (Sorin Group, Saluggia, Italy) via ministernotomy.

Methods: Seventy-two patients (43 women, 29 men; mean age 77.

Frequency of and determinants of stroke after surgical aortic valve replacement in patients with previous cardiac surgery (from the Multicenter RECORD Initiative).

Surgical aortic valve replacement (S-AVR) after previous cardiac surgery is expected to be associated with a high rate of adverse events. The aim of this study was to estimate the rate and identify the determinants of postoperative stroke in these patients. This is a multicenter study including 741 patients who underwent S-AVR after previous cardiac surgery.

The Perceval S aortic valve has the potential of shortening surgical time: does it also result in improved outcome?

Background: Sutureless aortic valve prostheses have the potential of shortening surgical time. However, whether shorter operative times may also result in improved patient outcomes remains to be established.

Methods: One hundred patients underwent minimally invasive isolated aortic valve replacement.

Sternal wound dehiscence from intense coughing in a cardiac surgery patient: could it be prevented?

This case report is on a obese patient who underwent a coronary artery bypass. The immediate postoperative phase, on the 8th day, was characterized by sternal dehiscence with diastasis, from intense coughing. At present, for obese patients there are not any guidelines aimed to prevent the sternal diastasis.

Homografts in aortic position: does blood group incompatibility have an impact on patient outcomes?

Objectives: Aortic homografts are an alternative to mechanical or biological valve prostheses. Homografts are generally not transplanted ABO-compatible while this policy is still under debate. The purpose of this study was to investigate whether ABO compatibility impacts on long-term outcomes or not.

[Prosthetic valve endocarditis 6 months after transcatheter aortic valve implantation].

Susceptibility to endocarditis after transcatheter aortic valve implantation (TAVI) has not yet been described. We report the first case of acute aortic prosthetic valve endocarditis in a patient undergoing transapical TAVI, successfully treated with surgery. In November 2009, an 83-year-old woman underwent TAVI (23 mm Edwards Sapien) with an uneventful postoperative course.

[Degenerated mitral bioprosthesis and severe aortic valve stenosis in a high-risk patient: a two-step transcatheter valve implantation].

Recently, small case series have described successful off-label use of transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic valves in mitral position. We here report the case of a 78-year-old female patient who underwent TAVI for severe aortic stenosis and transapical valve-in-valve implantation for degenerated mitral bioprosthesis. There was no evidence of intraprosthetic regurgitation and/or paraprosthetic leaks on control angiography and transesophageal echocardiography.

A staged approach to transcatheter aortic valve implantation and mitral valve-in-valve implantation for a degenerated bioprosthesis in a high-risk patient.

Recently, small case series have described the successful off-label use of transcatheter valve implantation in patients with degenerated bioprosthetic valves in the mitral position. We report here the case of a 78-year old female patient who underwent transcatheter aortic valve implantation for severe aortic stenosis and transapical valve-in-valve implantation for a degenerated mitral bioprosthesis. There was no evidence of intraprosthetic regurgitation and/or paraprosthetic leakages on control angiography and transoesophageal echocardiography.

Sutureless aortic valve replacement: first-year single-center experience.

Background: Sutureless aortic bioprostheses bear the potential of easy implantation, reduced ischemic time, and surgical trauma in aortic valve replacement. We herein show our clinical and echocardiographic results after a 1-year experience with a new sutureless bioprosthesis.

Methods: The Perceval S (Sorin Biomedica Cardio Srl, Saluggia, Italy) is a pericardial aortic prosthesis assembled within a super-elastic alloy frame.

Perceval S aortic valve implantation in mini-invasive surgery: the simple sutureless solution.

The Perceval S bioprosthesis (21 and 23 mm) was approved for clinical use in December 2010 and it is now routinely used. This bioprosthesis is suggested for the treatment of patients undergoing minimally-invasive surgery for reasons of safety and reduction in implantation time. Here we describe the use of the Perceval bioprosthesis in patients undergoing minimally invasive cardiac surgery.

A supra-annular malposition of the Perceval S sutureless aortic valve: the 'χ-movement' removal technique and subsequent reimplantation.

The Perceval S sutureless valve prosthesis has recently been introduced as a new biological aortic valve prosthesis, but a specific learning curve is required, as for every cardiac surgical centre dealing with a new technique. After the removal of the stenotic valve, the prosthetic valve is correctly positioned within the mildly decalcified aortic annulus. When a supra-annular malposition occurs, due to an excessively rapid release of the prosthesis in the aorta or incomplete annular visualization, the Perceval S valve can safely be removed even after balloon dilation.

Stentless pericardial valve for acute aortic valve endocarditis with annular destruction.

Surgery for aortic-valve endocarditis is still challenging, particularly in combination with destruction of the annulus. Freedom Solo (Solo) is a bovine stentless prosthesis for aortic valve replacement. It is implanted supra-annularly into the aortic wall with a single suture line, without requiring an 'intact' annulus.

Perceval sutureless aortic valve prosthesis: easy, fast, and safe.

Objective: There is an increase of old patients needing aortic valve surgery. Especially in this age group, a lot of new less-invasive strategies are proposed. Our goal was to study whether a sutureless aortic valve, which is implanted surgically after removal of the native valve, could be an alternative for a subgroup of patients.