Early Outcomes of Sutureless Aortic Valves

Abstract

BackgroundIn elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation.MethodsBetween October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used.ResultsThe mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%.ConclusionIn the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Risk Factors for Postoperative Pacemaker Implantation After Rapid Deployment Aortic Valve Replacement: Results from the RADAR Registry

“…The design allows for rapid implantation and thus facilitates the adoption of minimally invasive surgical approaches [8,9]. Excellent results have been reported in terms of morbidity and mortality, with a consistent reduction in surgical and inhospital stay compared to patients undergoing AVR with conventional bioprosthesis [12,13]. The RADAR registry was initiated in Spain with the main objective of demonstrating the safety and efficacy of RDAV replacement.…”

Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures

“…The Perceval S and Edwards Intuity valves are approved for clinical use in Europe and Turkey, and we have used them often. 7,8…”

Sutureless Aortic Valve Replacement

“…Studies have shown that sutureless aortic valves reveal a significant reduction of gradients postoperatively. 3,14,15 D'Onofrio et al observed that transapical and sutureless valves have lower mean aortic gradients than conventional aortic valve replacements. studies, in isolated sutureless AVR patients, cross-clamp and CPB times were 33 and 57 minutes.…”

“…Clinical studies show improved left ventricular systolic and diastolic function due to the regression of left ventricular hypertrophy after aortic valve replacement. 3,4 Biologic aortic valves are preferred to reduce postoperative gradient levels and avoid complications related to warfarin use in elderly patients with aortic stenosis.…”