Sutureless Valve Implantation in Sievers Type 0 Bicuspid Annuli: A Word of Caution

J Card Surg. 2015 Sep;30(9):694-6. doi: 10.1111/jocs.12599. Epub 2015 Jul 30.

Abstract

Aim: We describe a series of 3f Enable sutureless prostheses implanted in bicuspid valves.

Methods: Between March 2011 and April 2014, five patients with Sievers type 0 bicuspid valves were selected to receive the sutureless 3f Enable prosthesis . Exclusion criteria were: intraoperative calibration of the aortic annulus >27 mm, left ventricle ejection fraction <50%, age <70 years.

Results: All the implantations could be performed without the necessity to re-deploy the prosthesis . The perioperative transesophageal echocardiogragram detected two moderate paravalvular leakages (PVL) in two patients who received a large size of prosthesis (25 and 27 mm, respectively). The two leakages, at a follow-up of 32 and 24 months, respectively, increased to grade II and II +. No PVL appeared in the other three patients.

Conclusion: This experience should warn about the inadequate performance of the 3f Enable valve in Sievers type 0 large aortic bicuspid annuli. In this subset any minor intraoperative residual leakage should not be accepted.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / abnormalities*
  • Aortic Valve / surgery
  • Bicuspid Aortic Valve Disease
  • Echocardiography, Transesophageal
  • Follow-Up Studies
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Stroke Volume
  • Sutures