Primary Implantation Failure
Primary implantation failed in 14 patients (14%) but finally 100
patients (97%) benefited of a Percaval-S implantation. This very high
rate of primary implantation failure (compared to current
literature18–20) is explained because we considered
any situations where a second valve deployment was required even if the
same Perceval-S was reemployed. Fail situations are described in Figure
3.
In three patients (21%), the valve exhibited an obvious instability
after its deployment and was redeployed in good position before closing
the aorta, with an additional SCAP in one patient. In the 11 other
patients (79%), a paravalvular leak was identified after weaning CPB,
requiring a second clamping to attempt to settle this issue. In seven
patients (50%), the same Perceval-S was redeployed in good position,
with an additional SCAP in three patients. In one case (7%), the valve
size needed to be increased from M to L. In the three remaining cases
(21%), the Perceval-S valve was replaced by a sutured bioprosthesis
(Trifecta St Jude Medical, MI, USA); in two of these, a total aortic
root replacement had to be performed using a Freestyle aortic root
bioprosthesis (Medtronic, Dublin, Ireland). Overall, SCAP enabled the
implantation of Perceval-S in four patients (29%) in whom the first
implantation had failed.