Outcomes of sutureless aortic valve replacement versus conventional aortic valve replacement and transcatheter aortic valve replacement, updated systematic review, and meta‐analysis

Kim, Kevin S; Makhdoum, Ahmad; Koziarz, Alex; Gupta, Saurabh; Alsagheir, Ali; Pandey, Arjun; Reza, Seleman; Um, Kevin J.; Teoh, Kevin; Alhazzani, Waleed; Lamy, André; Yanagawa, Bobby; Belley‐Côté, Emilie P.; Whitlock, Richard

doi:10.1111/jocs.16044

Cited by 4 publications

(9 citation statements)

References 86 publications

(387 reference statements)

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“…77,78 Despite considerable improvement in the rate of PPI over the last 11 years (12.8% down to 5.9%) secondary to increased user experience and avoidance of valve oversizing, the rate of PPI remains significantly higher than following SAVR. 17,79,80 Paravalvular leak. The rate of overall PVL post-SUAVR ranges from 0.8% to 11%.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…Critically, contemporary pooled analyses report equivalent rates of PVL following SUAVR and SAVR and reduced PVL with SUAVR than with TAVR. [80][81][82] Patient-prosthesis mismatch. With standard sutured AVR, the rate of PPM ranges from 20% to 70%.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…70,71 SUAVR does not appear to come with an equivalent risk of IE compared with SAVR and TAVR. 80 Bleeding. Rates of major bleeding following SUAVR range from 1.3% to 9.4%.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…70 SUAVR does not increase the risk of major bleeding or the requirement for blood transfusions as compared with SAVR. 80 Comparison With Other Prosthetic Valve Replacement SAVR. Several systematic reviews and meta-analyses have sought to determine whether SUAVR is superior to conventional sutured AVR.…”

Section: Clinical Outcomesmentioning

confidence: 99%

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The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology

Fialka,

EL-Andari,

Wang

et al. 2024

Innovations�(Phila)

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Objective: The surgical treatment of aortic stenosis continues to evolve, and sutureless aortic valve replacement (SUAVR) is an emerging technology. With the Perceval S (Corcym, London, UK) as the only true sutureless valve on the market, the objective of this review is to analyze the current literature on Perceval S. Focusing on valve design and deployment as well as applications of the technology for challenging pathology, clinical outcomes are assessed, including a comparison with transcatheter AVR (TAVR). Methods: PubMed and MEDLINE were searched by 3 authors for studies analyzing SUAVR from inception to May 19, 2023. Results: SUAVR facilitates minimally invasive surgery and offers an alternative strategy for patients with small aortic annuli. It also has a time-saving advantage for patients who require complex operations. SUAVR results in excellent long-term morbidity, mortality, durability, and hemodynamic function. In comparison with conventional surgical AVR (SAVR), SUAVR does have a greater risk of postoperative pacemaker implantation; however, increasing user experience and refinements in implantation technique have contributed to reductions in this outcome. SUAVR results in morbidity and mortality that is similar to rapid-deployment AVR. Midterm outcomes are superior to TAVR; however, further robust investigation into all of these comparisons is ultimately necessary. Conclusions: SUAVR bridges the gap in technology between SAVR and TAVR. The application of this exciting technology will undoubtedly grow in the coming years, during which additional investigation is paramount to optimize preoperative planning, valve deployment, and reintervention strategies.

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Section: Clinical Outcomesmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

“…70,71 SUAVR does not appear to come with an equivalent risk of IE compared with SAVR and TAVR. 80 Bleeding. Rates of major bleeding following SUAVR range from 1.3% to 9.4%.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology

Fialka,

EL-Andari,

Wang

et al. 2024

Innovations�(Phila)

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show abstract

“…Compared to SAVR, TAVI is associated with lower mortality, shorter length of hospital stays, and a more rapid return to normal life [ 3 , 4 , 5 , 6 ]. In contrast, patients undergoing SAVR have a lower risk of paravalvular regurgitation, permanent pacemaker implantation, and need for secondary valve intervention [ 7 , 8 , 9 ]. Thus, according to current European and American guidelines for the management of valvular heart disease, TAVI is favored in frail patients who are aged over 75 or 80 years, or who have a reduced life expectancy or a high surgical risk [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Cerebral Tissue Oxygen Saturation Is Enhanced in Patients following Transcatheter Aortic Valve Implantation: A Retrospective Study

Schmidt

Kreissl

Vigelius-Rauch

et al. 2022

JCM

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Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement. The aim of this study was to evaluate whether a relevant alteration in cerebral tissue oxygen saturation (rSO2) could be detected following TAVI. Retrospective data analysis included 275 patients undergoing TAVI between October 2016 and December 2020. Overall, rSO2 significantly increased following TAVI (64.6 ± 10% vs. 68.1 ± 10%, p < 0.01). However, a significant rise was only observed in patients with a preoperative rSO2 < 60%. Of the hemodynamic confounders studied, hemoglobin, mean arterial pressure and blood pH were lowered, while central venous pressure and arterial partial pressure of carbon dioxide (PaCO2) were slightly elevated (PaCO2: 39 (36–43) mmHg vs. 42 (37–47) mmHg, p = 0.03; pH: 7.41 (7.3–7.4) vs. 7.36 (7.3–7.4), p < 0.01). Multivariate linear regression modeling identified only hemoglobin as a predictor of altered rSO2. Patients with a EuroScore II above 4% and an extended ICU stay were found to have lower rSO2, while no difference was observed in patients with postoperative delirium or between the implanted valve types. Further prospective studies that eliminate differences in potential confounding variables are necessary to confirm the rise in rSO2. Future research should provide more information on the value of cerebral oximetry for identifying high-risk patients who will require further clinical interventions in the setting of the TAVI procedure.

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Sutureless Valves, a “Wireless” Option for Patients With Aortic Valve Disease

Spadaccio,

Nenna,

Pisani

et al. 2024

Journal of the American College of Cardiology

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Outcomes of sutureless aortic valve replacement versus conventional aortic valve replacement and transcatheter aortic valve replacement, updated systematic review, and meta‐analysis

Cited by 4 publications

References 86 publications

The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology

The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology

Cerebral Tissue Oxygen Saturation Is Enhanced in Patients following Transcatheter Aortic Valve Implantation: A Retrospective Study

Sutureless Valves, a “Wireless” Option for Patients With Aortic Valve Disease

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