Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series
Nezafati, Pouya, Uchime, Chimezi, and Yadav, Sumit (2025) Perceval prosthesis implantation into challenging degenerated aortic valves: a literature review and case series. Journal of Cardiothoracic Surgery, 20 (1). 331.
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Abstract
Background: The Perceval Sutureless prosthesis can increase the effective orifice area (EOA) and reduce the chance of prosthesis–patient mismatch (PPM). This report presents three patients with challenging degenerated bioprosthetic valves undergoing redo aortic valve replacement (rAVR) using the Perceval (LivaNova, London, UK) prosthesis from a cohort of more than 300 performed cases and a review of the literature on the management of challenging degenerated valves. Methods: Case 1: Degenerated 23 mm Trifecta with the valve cage densely adherent to the annulus. Cage with sewing ring were excised and annulus sized to a large Perceval valve. Case 2: Degenerated 29 mm Epic from a Bentall’s procedure. Calcified and rigid prosthetic leaflets as well as stent posts were excised and XL Perceval implanted. Case 3: Degenerated 27 mm Epic with signs of endocarditis from a history of Bentall’s procedure. Three calcified leaflets of the Epic valve were completely excised. The orifice accepted a medium Perceval. Results: The total Cardiopulmonary Bypass (CPB) and aortic cross clamp (ACC) times (in minutes) were 99.76, 117.68 and 143.99 in Cases 1, 2 and 3, respectively. Moreover, post-implantation transesophageal echocardiogram (TOE) demonstrated a well-seated valve, no paravalvular leak in all cases and a peak gradient of 12.7 mmHg, 14.8 mmHg and 17.7 mmHg in Cases 1, 2 and 3, respectively. Conclusion: The Perceval prosthesis is an excellent choice for rAVR, as it can safely simplify challenging cases at risk of PPM and is an excellent valve-in-valve alternative to degenerated or infected Bentall valves with patent graft. The Perceval prosthesis can be well seated on the different structures of a degenerated bioprosthetic valve.
| Item ID: | 87706 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1749-8090 |
| Keywords: | Aortic valve replacement, Degenerated aortic valve, Perceval |
| Copyright Information: | © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. |
| Date Deposited: | 28 Jan 2026 04:21 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320226 Surgery @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 50% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100% |
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