First Case of Aortic Valve Replacement with the Perceval Sutureless Aortic Valve during Left Ventricular Assist Device Implantation

Vera Hergesell, Oleg Novoseltsev, Klemens Ablasser, Nicolas Verheyen, Peter Oberwalder, Otto Dapunt, Sotirios Spiliopoulos

Medical University Graz, Graz, Austria

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – A

Abstract

Objectives

Replacement of a regurgitant aortic valve is mandatory in cases of left ventricular assist device (LVAD) implantation. We report the first case of aortic valve replacement with the Perceval Sutureless Aortic valve during implantation of the HeartMate III device in an end- stage heart failure patient.

Methods

A 55 years old male, Caucasian patient on veno-arterial ECMO- support without any signs of myocardial recovery (INTERMACS 1) underwent conventional implantation of the HeartMate III LVAD in a Bridge to Transplantation setting. Moderate aortic valve insufficiency was documented by transoesophageal echocardiography in the preoperative setting.

Results

Following aortic clamping (33 minutes) and cardioplegic arrest, native aortic valve was excised and a Perceval Sutureless Aortic Valve (Size L) was conventionally implanted. After initiation of LVAD support echocardiography revealed a well seating valve prosthesis with regular opening and closing motion of the leaflets. At follow- up (10 days) maximal flow velocity was 1.60 m/s, mean transvalvular gradient 5.64 mmHg and maximal transvalvular gradient 10.28 mmHg. Unfortunately, the patient died 13 days after implantation as a result of urinary sepsis resulting in multiorgan failure.

Conclusions

The Perceval Sutureless Aortic Valve can be safely implanted in cases of LVAD therapy. Haemodynamic performance and leaflet motion are satisfactory. However long- term results in larger patient cohorts are still necessary.