Supra-Annular Perceval Bentall: From Concept to Patient

This technical report describes the SUpra-annular PERceval Bentall (SUPERB), which utilized a Perceval Plus XL sutureless bovine pericardial valve inside a 28 mm Valsalva Dacron graft. Ex vivo testing involved deploying the Perceval XL into 26-32 mm Dacron grafts: the 26 mm graft caused 17 percent oversizing with possible infolding, the 28 mm graft gave optimal 8 percent inflow ring oversizing, the 30 mm graft yielded only 1 percent oversizing, and the 32 mm graft was deemed too large. Using a ViVitro pulse duplicator system to simulate cardiac pressure and flow conditions, stable valve position and function under both normotensive and hypotensive testing were confirmed. The first clinical case was a 75-year-old man with severe aortic stenosis and a 4.5 cm root aneurysm. The authors conclude that the SUPERB may simplify Bentall sizing and mitigate patient-prosthesis mismatch.