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dc.contributor.authorCasha, Aaron-
dc.contributor.authorManche, Alexander-
dc.contributor.authorCamilleri, Liberato-
dc.contributor.authorYamagata, Kentaro-
dc.contributor.authorSantucci, Stephanie-
dc.contributor.authorGauci, Marilyn-
dc.contributor.authorGalea, Joseph-
dc.date.accessioned2017-10-19T07:31:13Z-
dc.date.available2017-10-19T07:31:13Z-
dc.date.issued2017-
dc.identifier.citationCasha, A. R., Manché, A., Camilleri, L., Yamagata, K., Santucci, S., Gauci, M., & Galea, J. (2017). Sutureless perceval aortic valve implantation compared with conventional mitroflow valve replacement. Indian Journal of Thoracic and Cardiovascular Surgery, 1-7.en_GB
dc.identifier.urihttps://www.um.edu.mt/library/oar//handle/123456789/22851-
dc.description.abstractBackground Patients at a high operative risk for conventional aortic valve replacement (AVR) may be offered sutureless valve implantation. Sutureless valves resemble conventional valves but incorporate an anchoring mechanism and features to circumvent paravalvular leaks without requiring annular sutures. Haematological and echocardiographic parameters in sutureless Perceval and conventional Mitroflow valves were compared retrospectively using risk-matched controls. Methods Perceval and Mitroflow valve patients were matched for pre-operative risk status using logistic Euroscore risk stratification. Haematological and echocardiographic data was collected retrospectively. Independent t tests and Mann-Whitney tests were used to compare variables between groups, with a binomial logistic regression model to determine independent variables. Results The use of sutureless Perceval aortic valves results in lower red cell distribution width (RDW) p = 0.001 and lower white cell (WBC) counts p = 0.034 but also resulted in a postoperative drop in platelet counts in two thirds of patients p = 0.038. A platelet level below 80 × 109/L on postoperative day 2 lengthened hospital stay in Perceval patients by 4.7 days, p = 0.050. Perceval implantation lead to lower crossclamp times p = 0.001 and bypass times p = 0.001 and reduced patient-prosthesis mismatch (p = 0.055). Conclusions Perceval stentless valves offer a promising alternative to conventional aortic valve replacement, with lower bypass and cross-clamp times, and an increase in indexed effective orifice area. The lower improved implantation time was associated with a lower post-operative RDW and WBC levels, indicating a muted systemic inflammatory response. The lower post-operative platelet counts delayed discharge but did not otherwise affect clinical outcome.en_GB
dc.language.isoenen_GB
dc.publisherIndian Association of Cardiovascular-Thoracic Surgeonsen_GB
dc.rightsinfo:eu-repo/semantics/restrictedAccessen_GB
dc.subjectHeart valves -- Surgeryen_GB
dc.subjectAortic valve -- Surgeryen_GB
dc.subjectHeart -- Surgeryen_GB
dc.subjectHeart -- Diseases -- Treatmenten_GB
dc.titleSutureless perceval aortic valve implantation compared with conventional mitroflow valve replacementen_GB
dc.typearticleen_GB
dc.rights.holderThe copyright of this work belongs to the author(s)/publisher. The rights of this work are as defined by the appropriate Copyright Legislation or as modified by any successive legislation. Users may access this work and can make use of the information contained in accordance with the Copyright Legislation provided that the author must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the prior permission of the copyright holder.en_GB
dc.description.reviewedpeer-revieweden_GB
dc.identifier.doi10.1007/s12055-017-0592-0-
dc.publication.titleIndian Journal of Thoracic and Cardiovascular Surgeryen_GB
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