Safety and Haemodynamic Outcomes of Currently Available Suture-less Aortic Valves in Patients With Aortic Stenosis: A Meta-Analysis

Amer, Mohamed; Jawad, Mohammed Abd Al; Omar, A.K. Mohd; Metwaly, Hany

doi:10.1016/j.hlc.2020.02.006

Cited by 4 publications

(3 citation statements)

References 38 publications

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“…Minimally invasive techniques, which take considerable operative time and come with a learning curve, can still fight back. The introduction of rapid deployment and sutureless valves can significantly cut the operative times and offer mini techniques to the high-risk aortic stenosis patients denied surgery before [Amer 2020;Tanaka 2021].…”

Section: Discussionmentioning

confidence: 99%

Mini Sternotomy and Mini Thoracotomy for Aortic Valve Replacement: Is There a Difference?

Mourad

Jawad

2021

HSF

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Background: Minimally invasive valve replacement is increasingly accepted among surgeons and patients alike. Ministernotomy and minithoracotomy are the most used incisions in the minimally aortic valve replacement. The superiority of one incision over the other still is debatable with a few centers having the opportunity to compare them head-to-head. Methods: A retrospective analysis of 260 patients, who underwent mini AVR, with 132 patients in the ministernotomy group and 128 patients in the minithoracotomy group. Operative details, mortality, wound cosmetics, and postoperative pain were among the primary end points. Results: A predominance of female gender has been observed in both groups. The cross-clamp and total bypass times were significantly lower in MS compared with the MT approach (63.61±16.115 vs. 70.75±33.274 min, P = 0.028, and 91.90±26.365 vs. 112.24±51.634 min, P < 0.001, respectively). The minithoracotomy group had significantly shorter lengths of wounds (5.1 ± 0.6 vs. 8.48±0.344 cm, P < 0.001). The ministernotomy group had significantly lower postoperative pain scores either in the ICU, at hospital discharge, or after 30 days at the outpatient clinic, where scores compared with MT (4.46±1.23 vs. 5.23±1.12, P < 0.001, 1.6±0.84 vs. 1.83±0.72, P = 0.019, and 1.28±0.67 vs. 1.47±0.53, P = 0.012, respectively). Conclusion: Both minimally invasive incisions for AVR proved their safety and efficacy. While the ministernotomy has the advantage of less postoperative pain and pleural complications, the minithoracotomy incision has its unmatched aesthetic appeal.

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Section: Discussionmentioning

confidence: 99%

Mini Sternotomy and Mini Thoracotomy for Aortic Valve Replacement: Is There a Difference?

Mourad

Jawad

2021

HSF

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“…Current SURD valve technologies were introduced about 15 years ago to reduce operative times and facilitate minimally invasive techniques 2,3 . Additionally, SURD-AVR demonstrated to improve valve hemodynamic and facilitate valve prosthesis implantation in challenging anatomical settings 4,5 . Recently, however, conflicting clinical results have been reported in observational studies comparing SURD-AVR and sutured AVR (s-AVR) 6,7 .…”

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confidence: 99%

Sutureless and rapid deployment versus sutured aortic valve replacement: a propensity-matched comparison from the Sutureless and Rapid Deployment International Registry

Berretta

Andreas

Meuris

et al. 2022

European Journal of Cardio-Thoracic Surgery

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Objective To compare procedural and in-hospital outcomes of patients undergoing sutureless (Perceval, Livanova PLC, London, UK) and rapid deployment (Intuity Elite, Edwards Lifesciences, Irvine, USA) aortic valve replacement (group 1) versus sutured aortic valve replacement (group 2). Methods Patients receiving isolated aortic valve replacement between 2014 and 2020 were analysed using data from the Sutureless and Rapid Deployment International Registry. Patients in group 1 and group 2 were propensity-score matched in a 1:1 ratio. Results A total of 7708 patients were included in the study. After matching, 2 groups of 2643 each were created. Patients in group 1 were more likely to undergo minimally invasive approaches and were associated with shorter operative times when compared with group 2. Overall in-hospital mortality was similar between groups. While an increased risk of stroke was observed in group 1 in the first study period (2014–2016) (relative risk 3.76, p < 0.001), no difference was found in more recent year period (relative risk 1.66, p = 0.08)(p for heterogeneity 0.003). Group 1 was associated with reduced rates of postoperative low cardiac output syndrome, atrial fibrillation and mild aortic regurgitation. New pacemaker implant was three-fold higher in group 1. Conclusions Our findings showed significant differences in procedural and clinical outcomes between the study groups. These results suggest that sutureless and rapid deployment aortic valve replacement should be considered as part of a comprehensive valve program. The knowledge of the respective post-aortic valve replacement benefits for different valve technologies may result in patient-tailored valve selection with improved clinical outcomes.

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“…The risk of moderate and severe patient-prosthesis mismatch (PPM) is 18.8% and 4.8%, respectively, with Intuity is higher than that reported for Perceval as expected given that it is a stented valve. 15 PPM is clinically important, as severe PPM increases structural valve degeneration and short and long-term mortality. [16][17][18][19] Mild paravalvular leak is reasonable at 2.4% but higher than that for SAVR.…”

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confidence: 99%

Rapid deployment valves: Another tool in the toolbox

Tanaka

Nedadur

Yanagawa

2021

Journal of Cardiac Surgery

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Safety and Haemodynamic Outcomes of Currently Available Suture-less Aortic Valves in Patients With Aortic Stenosis: A Meta-Analysis

Cited by 4 publications

References 38 publications

Mini Sternotomy and Mini Thoracotomy for Aortic Valve Replacement: Is There a Difference?

Mini Sternotomy and Mini Thoracotomy for Aortic Valve Replacement: Is There a Difference?

Sutureless and rapid deployment versus sutured aortic valve replacement: a propensity-matched comparison from the Sutureless and Rapid Deployment International Registry

Rapid deployment valves: Another tool in the toolbox

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