A Meta-Analysis Examining Differences in Short-Term Outcomes between Sutureless and Conventional Aortic Valve Prostheses

Hurley, Eoghan T.; O’Sullivan, Katie E.; Segurado, Ricardo; Hurley, John P.

doi:10.1097/imi.0000000000000221

Cited by 20 publications

(15 citation statements)

References 48 publications

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“…The reported incidence of pacemaker implantation ranges from 5.6 to 9.1% in the literature 19, 20 , worse than standard AVR (3.0%). Other significant complications include neurological events (transient ischemic attack or disabling stroke), myocardial infarction, kidney failure, and surgical site infections 21 .…”

Section: Sutureless Aortic Valve Replacement: Technique and Resultsmentioning

confidence: 99%

Recent advances in aortic valve replacement

Spadaccio

Alkhamees²,

Al‐Attar

2019

F1000Res

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Aortic valve replacement has stood the test of time but is no longer an operation that is exclusively approached through a median sternotomy using only sutured prostheses. Currently, surgical aortic valve replacement can be performed through a number of minimally invasive approaches employing conventional mechanical or bioprostheses as well as sutureless valves. In either case, the direct surgical access allows inspection of the valve, complete excision of the diseased leaflets, and debridement of the annulus in a controlled and thorough manner under visual control. It can be employed to treat aortic valve pathologies of all natures and aetiologies. When compared with transcatheter valves in patients with a high or intermediate preoperative predictive risk, conventional surgery has not been shown to be inferior to transcatheter valve implants. As our understanding of sutureless valves and their applicability to minimally invasive surgery advances, the invasiveness and trauma of surgery can be reduced and outcomes can improve. This warrants further comparative trials comparing sutureless and transcatheter valves.

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Section: Sutureless Aortic Valve Replacement: Technique and Resultsmentioning

confidence: 99%

Recent advances in aortic valve replacement

Spadaccio

Alkhamees²,

Al‐Attar

2019

F1000Res

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“…Ranucci et al reported that ACC time was an independent predictor of cardiovascular morbidity, and there was a 1.4% increase in relative risk in morbidity for every extra 1-minute cross-clamp time (5) . This relationship has been demonstrated recently, even in AVR surgery, which has shorter ACC times compared to other cardiac surgery operations (5) (6,7) .…”

Section: Discussionmentioning

confidence: 63%

Comparison of Perioperative Results of Sutureless and Conventional Valves in Aortic Valve Replacement Surgery

Öztürk

Adademir

Başar

et al. 2020

Kosuyolu Heart Journal

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Introduction: This study aimed to evaluate the early and midterm results of sutureless and conventional bioprosthetic valves in patients who underwent aortic valve replacement (AVR) due to aortic stenosis. Patients and Methods:Patients who underwent a bioprosthetic AVR due to aortic stenosis in our institution between 2012 and 2017 were included in our study. The patients were divided into two groups on the basis of type of aortic valve prosthesis used as a sutureless valve (SU-AVR) (n= 62) and a conventional valve (C-AVR) (n= 69). Results:The EuroSCORE II in the sutureless group was found to be significantly higher as compared to the conventional group (p= 0.0121). Patients in the sutureless group underwent more mini-incisional approaches: 22 (36%) versus 4 (6%, p= 0.0002). The mean aortic cross-clamp and cardiopulmonary bypass time were significantly lower in the sutureless group as compared to the conventional one (53.8 ± 34.2 vs. 79.2 ± 36.3 minutes and 87.5 ± 40.7 vs. 117.4 ± 66.3 minutes, p< 0.0001). The mean follow-up time was 19.5 ± 15.7 months in the sutureless group and 28.0 ± 21.0 months in the conventional group. The overall survival rate of the sutureless and the conventional group was found to be 72.6% and 78.3%, respectively, (p= 0.253) when Kaplan-Meier analysis was done. Conclusion:Although SU-AVR patients are found to have a higher preoperative risk score compared to the conventional group, yet it can be performed with comparable mortality and morbidity to C-AVR. Therefore, SU-AVR is a promising alternative to C-AVR, especially in elderly and high-risk patients with comorbid diseases.

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“…Data published on the comparison between RD-AVR and SAVR underline the benefits of RD-AVR in terms of operative time reduction, CBP duration and increased effective orifice area and consequent lower postoperative transvalvular gradient [19] . The most common complications reported in the case of RD-AVR are higher incidence of pacemaker implantation, postoperative stroke and residual aortic regurgitation [20] , while the most common complications reported in the case of standard procedure tend to be exclusively surgery related as major bleeding or acute renal failure [21] . Totally in contrast to these previous studies, the German Aortic Valve Registry (GARY) recently analyzed a total of 22,062 patients who underwent isolated SAVR using SAVR or RD-AVR between 2011 and 2015 [22] .…”

Section: Discussionmentioning

confidence: 99%

Bridging aortic valve surgery to 21st century: what can a surgeon do?

D'Abramo¹,

Ferrante²,

Guimarães³

et al. 2019

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Aortic valve stenosis is the most clinically relevant valvular heart disease in the elderlies. Surgical aortic valve replacement (SAVR) represented, for decades, the standard of care for the treatment of severe aortic stenosis. Although SAVR still represents a valid option in this clinical scenario, transcatheter aortic valve implantation proved to be superior to medical therapy and comparable to SAVR in several randomized trials in patients at high or intermediate operative risk. At the same time, the growing aging population carrying on greater morbidities and high risk profiles has led to the development of minimally invasive technologies, as rapid deployment aortic valve replacement or Sutureless, to minimize surgical impact on patients. The Heart Team is nowadays tasked to determine the best option tailored for each patient considering patient-related factors and mastering all the surgical options in terms of both different techniques and types of available valves. Nevertheless, some open issues need to be already answered as: which has the longest durability, which the lower complication rate and the lower overall mortality. The aim of this review is to briefly resume the main features of these different options and explore what kind of open questions these newer-generation prosthetic valves and delivery devices carry.

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A Meta-Analysis Examining Differences in Short-Term Outcomes between Sutureless and Conventional Aortic Valve Prostheses

Cited by 20 publications

References 48 publications

Recent advances in aortic valve replacement

Recent advances in aortic valve replacement

Comparison of Perioperative Results of Sutureless and Conventional Valves in Aortic Valve Replacement Surgery

Bridging aortic valve surgery to 21st century: what can a surgeon do?

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