Thread by @dr_benoy_n_shah

#EACTS2020 Update

Abstract - PERSIST-AVR RCT

Well, had to choose this! Not often there's a RCT in heart valve disease!

Study: Perceval sutureless valve vs a stented tissue aortic valve, both by full sternotomy and mini sternotomy approaches

@EACTS @BrHeartValveSoc

47 sites across 3 continents recruiting from 2016-2018

578 underwent isolated AVR

Mean age 75yrs

Authors report quicker surgery and better outcomes for the Perceval valve *in combination with* mini-sternotomy approach

Authors conclude that sutureless valve in combination with minimal sternotomy approach is best option

#EACTS2020 cardiac commentary!

Sutureless valves are interesting because with advent of TAVI, there's lots of questions about exact role and which patient cohort(s) are best suited to this technology.

These are early outcomes only (1yr) so of course, longer term data needed

Just like with TAVI, the pacemaker rate was *far* higher with sutureless (rapid deployment) than conventional stented bioprosthesis valves by mini-sternotomy (11% vs 1.6%!)

Would also be good to know details of how hard they tried to get new AF patients back to SR - DCCV used?

This data is also slightly at odds with data from GARY registry which found a higher incidence of stroke, not lower, with sutureless valves (admittedly not just Perceval valve in that registry)

So, I still don't know exactly where this technology fits in, but I'm sure the minimally invasive approach should be embraced. Future iterations of the valve may help reduce pacing rates.

Finally, just like with the TAVI studies, no surprise to see the Disclosures slide!

@EACTS @SCTSUK @ctsnetorg @TheBJCA @global_wic @HeartValveOrg @SABOURETCardio @mariovar55 @M_Pompeu_Sa_MD @pomyers @VictorDayan1 @JessicaLuc1 @iamritu @purviparwani @difersan2 @ovidiogarciav @MMarinCuartas @NMerke @Chestcracker @RODRIGOVISCONT1 @MadalinaGarbi @JGrapsa
#EACTS2020