Perceval allows precise positioning both in MICS and traditional surgery45,62   Age is one of the most important factors when making the decision between a mechanical and tissue valve. Della Barbera M. - Pre-implantation collapse in the Sorin Perceval S Sutureless prosthesis does not affect pericardial graft structure. Neither mechanical nor tissue valves have been definitively associated with longer survival or fewer complications. It is designed to be highly versatile and suitable for a wide range of surgical approaches, including traditional and minimally invasive. In general, the types of valves can be divided into two categories: tissue valves and mechanical valves, each with its own unique characteristics. In your deliberations, you should think about how long the tissue valve will last and what to do when it wears out. Tissue valves do not require lifelong blood thinners, such as warfarin (Coumadin) or some of the newer medicines, like apixaban (Eliquis). The sinusoidal struts allow identification of clear landmarks which may help avoid coronary ostia obstruction (at annulus level. Infective endocarditis is a severe condition which occurs on native as well as on artificial valves. Gilmanov D. et al. Perceval valves have a large internal diameter, providing more choice for future transcatheter valve selection. While tissue valves are not as long-lasting as mechanical valves, they do not usually require long-term use of blood thinner medicines. Perceval is a valuable option to reduce post-operative complications1,52,62 Gilmanov D. et al. 22. The valve can be replaced, but that involves another heart operation. guidance (no failure after 600 million cycles). Why? It has shown excellent results in terms of durability.37,22, Examination of the results after collapsing and deployment revealed optimal cusp cooptation and absence of tears, perforation or folding.32, “Atraumatic insertion of the device with self-anchoring of the prosthetic valve into its final position, minimizing the risk for iatrogenic aortic dissection or thromboembolic stroke”52. %PDF-1.5 %���� - Ann Thorac Surg. 45.   Lifestyles choices, including playing contact sports, planning to have children, or having a job that prohibits blood thinners (i.e., active duty military) may result in your doctor recommending a tissue valve. Phan K. et al. The Perceval stent is able to adapt to the movements of the aorta during the cardiac cycle. Please wait. The disadvantage of tissue valves is that they wear out after about 12 to 15 years. surgical technique with cardiopulmonary bypass (CPB), aortic. The elasticity and shape of the stent are designed to: Collapse the valve for atraumatic and precise positioning. - Eur J Cardiothorac Surg. 2013 Dec;96(6):2101-8. - European multicentre experience with the sutureless Perceval valve: clinical and haemodynamic outcomes up to 5 years in over 700 patients. - Ann Thorac Surg 2012;94:504 –9 Precise positioning: the temporary guiding sutures guide the valve along the annulus axis even in narrow spaces. Valve-in-Valve procedures in a Perceval valve should be performed according to indications provided by the transcatheter valve manufacturer. The service you are trying to submit to is unavailable. The inflow ring can be evenly andcircumferentially expanded to accommodate transcatheter aortic valve placement. 2013 Dec;96(6):2101-8. Santarpino G. et al. Transcatheter valves are placed without open surgery and, in most cases, with a catheter through an artery in the groin.  Perceval helps reducing complexity even in challenging and time consuming procedures52,62, With a reproducible surgical technique: For most tissue valve patients, taking an aspirin a day is sufficient therapy.3 However, approximately 1/3 of patients with a tissue valve do not benefit from this, because they have a blood thinner requirement for other heart or vascular cond… terms of mortality, morbidity, and hemodynamic performance. The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons. Perceval features a distinctive design built around a superelastic stent, with unique features and mechanical behavior. If you are considering valve replacement surgery, do your homework and talk with your doctor to determine the right choice for you. Facilitate minimally invasive procedures. LivaNova PLC - Registered in England and Wales - Registered No. In general, patients older than age 65 tend to receive tissue valves, while patients under age 60 tend to receive mechanical valves. 52. Age is one of the most important factors when making the decision between a mechanical and tissue valve. The Perceval valve passed a test 3 times harder than what is required by the I.S.O. 2015 Mar 6. pii: ezv040. Perceval provides significant clinical benefits for the patients: Both mechanical prosthetic devices and tissue heart valves are affected. - Ann Thorac Surg. In general, patients older than age 65 tend to receive tissue valves, while patients under age 60 tend to receive mechanical valves. Something went wrong. The issue you have the most control over is the type of valve you receive. A Website Presented by Cardiothoracic Surgeons Committed to Improving, The Patient Guide to Heart, Lung, and Esophageal Surgery, Lung, Esophageal, and Other Chest Diseases, Achalasia and Esophageal Motility Disorders. endstream endobj startxref 45. 62. 18. Please try again at a later time. - Ann Thorac Surg. This website uses cookies to offer you a better experience. - Ann Thorac Surg. Michael O. et al. 0 If the blood thinners are not taken properly, blood clots may form and potentially lead to strokes or prevent the valves from functioning properly. Lower mortality rates (< 3% even in older patients) 2, Early AV Block III leading to PM implantation 6% (late 1.4%), Early major paravalvular leak 1.4% (late 1%), International Valvular Surgery Study Group (IVSSG) - S. Updating settings. Shrestha M. et al. Increased visualization: the reduced collapsed profile prevents damage to the aortic wall enabling a full and direct view. Anticoagulation medication is a treatment prescribed by physicians and given to mechanical valve replacement patients and sometimes to tissue valve patients.   The primary advantage of tissue valves is that they usually do not require long-term blood thinner therapy (e.g. The elasticity and shape of the stent are designed to: Thanks to the absence of a suturing ring, the geometric orifice area is maximized providing excellent hemodynamics. - Sutureless perceval aortic valve replacement: results of two European centers. A tissue heart valve is made of biological tissue, usually from an animal, and can last about 10 to 20 years. et al. Surgical valve replacement can be performed through the front of the chest (by completely or partially dividing the breastbone) or from the side (by going between the ribs and not dividing any bones). In addition to valve durability, other factors to consider include the use of blood thinners and noise. 2013 May 11. 32. 2012 May;93(5):1483-8​, 1. On the other hand, if you have a condition that prevents the use of blood thinners, such as gastrointestinal bleeding or conditions that are associated with easy or frequent bleeding, you may prefer a tissue valve. It’s a personal preference, but definitely worth considering. Both types of tissue valves work well and have similar defining characteristics. - Ann Thorac Surg 2012;94:504, Find information regarding MRI safety, product manual libraries and more. The nitinol stent providesclear visibility under fluoroscopy. %%EOF This website uses cookies to offer you a better experience. - Sutureless Aortic Valve Replacement: First-Year Single-Center Experience. Shrestha M. et al. Perceval features a distinctive design built around a superelastic stent, with unique features and mechanical behavior. At your side in every day practice: Because there are a lot of valve replacement options and many approaches to performing the valve replacement.   The tissue may be bovine (cow) or porcine (pig) and constructed from the pericardium (the protective sac that surrounds the heart) or heart valve leaflet tissue. and F.D.A. A distinctive design built around a super elastic stent with unique features and mechanical behavior. All rights reserved. 09451374 - 20 Eastbourne Terrace, London, W2 6LG, United Kingdom. Please check your internet connection and try again. h�bbd```b``���A$�XD���,�`� �dT�\Q ��"�L �et,����20120�Mc`$������ � ~ Some patients don’t hear the noise, some like it, some don’t care, and others don’t like the sound. IM-00422 B. As demonstrated in the large pool of published clinical data, Perceval provides excellent clinical results, comparable to the current gold standard, and provides additional benefits in terms of smoother post operative course and  faster recovery for the patient: 1. I read and agree with LivaNova Privacy Policies. This decision has never been more complicated. Santarpino G. et al. - The Journal of Thoracic and Cardiovascular Surgery, Available online 6 October 2014, Pages The actual technique of implanting the valve is the same, regardless of the approach or the valve selected. - Cardiovascular pathology The truly sutureless solution in AVR: Ease of implant: traditional valves require from 15 to 18 permanent sutures. The elastic structure aims at reproducing the stress absorption properties of the native tissue at the valve commissures level. - Thourani Invited Commentary for: “Minimally invasive aortic valve replacement with Perceval S sutureless valve: Early outcomes and one-year survival from two European centers”. The Perceval tissue component is based on a double sheet design introduced by LivaNova in 1985. - The Perceval S Aortic Valve Has the Potential of Shortening Surgical Time: Does It Also Result in Improved Outcome? Shorter ischemic times (61% reduction) and ECC times. Currently, no long-term data exists to support the efficacy of the procedure. - European multicentre experience with the sutureless Perceval valve: clinical and haemodynamic outcomes up to 5 years in over 700 patients. If you have heart valve disease and find out that you need valve replacement surgery, one of the biggest decisions you may face is what type of valve to get. However, valve durability and individual patient survival are both unpredictable. - Sutureless aortic valve replacement: a systematic review and meta-analysis. *The decision of performing Valve in Valve procedures is at the discretion of the cardiologist and/or hospital’s heart team, following careful assessment of the individual circumstances of each patient.