Rapid Deployment Aortic Valve Replacement

Prior to the procedure, you will have a physical exam and testing. Your healthcare team comprehensively evaluates your heart and your health to determine the best course of treatment.

Possible tests may include:

• Cardiac catheterization
• Chest X-ray
• Computed tomography (CT) scan
• Echocardiogram (echo)
• Electrocardiogram (EKG)
• Blood tests and urine tests

If you’re approved for the procedure, your care team will share instructions to prepare for surgery, including:

• When you should start fasting prior to your procedure.
• If you should temporarily stop taking any of your medications.
• When to arrive at the hospital.
• Personal items to bring with you and what to leave at home.

Perceval sutureless aortic valve replacement generally follows these steps:

1. You will be given anesthesia to put you in a deep sleep-like state. During the surgery, you will not feel pain or be aware of what’s happening. You will not remember the surgery.
2. Unlike open surgery for aortic replacement, which requires the surgeon to open the chest by making a large incision through your breastbone (sternotomy), the Perceval procedure is performed through a smaller chest incision (called an upper partial sternotomy).
3. You will be connected to a heart-lung (cardiopulmonary) bypass machine, which allows the surgical team to temporarily and safely stop your heart. The heart-lung machine takes over the function of your heart and lungs during the operation.
4. During the procedure, after accessing the aorta through an incision (aortotomy), the surgeon removes the diseased aortic valve flaps (leaflets) and any calcification surrounding the valve.
5. The surgeon implants the collapsed Perceval valve into the aorta. Once the valve is in position, a balloon is inflated to expand the valve’s supporting stent, securing it in place.

After surgery you will spend a few days in the intensive care unit (ICU), where our medical staff will closely monitor you. After leaving the ICU, you will remain in the hospital for several days.

Patients who receive a Perceval valve are often surprised at how quickly their conditions improve and how soon they are able to return to normal daily activities such as walking, eating and bathing.

Potential risks and complications of Perceval sutureless aortic valve replacement procedure include:

• Abnormal heart rhythm (arrhythmia)
• Paravalvular leakage (blood backing into the heart through the valve)
• Endocarditis (a rare, potentially fatal infection of the heart’s inner lining)
• Valve failure that requires its removal (explantation)
• Stroke
• Death

Age, medical conditions and other factors affect the risk of complications. Your surgeon will discuss your risk factors and what can be done to optimize the success of your surgery.

Of all the major cardiovascular care centers in the U.S., UH Harrington Heart & Vascular Institute is one of the most active in enrolling patients for rapid deployment aortic valve replacement surgery. Related efforts include a development-stage program called “SAVR Same as TAVR” through which we will promote the use of the Perceval valve in combination with Enhanced Recovery After Surgery (ERAS) protocols. This program will allow patients to be discharged a day or two following minimally invasive aortic valve replacement surgery.