Should sutureless aortic valve replacement be preferred only for decreasing aortic crossclamp time?

Abstract

C, et al. Is the second internal thoracic artery better than the radial artery in total arterial off pump coronary artery bypass grafting? A propensity score-matched follow-up study.

Sutureless Aortic Valve and Pacemaker Rate: From Surgical Tricks to Clinical Outcomes

“…The balloon will be inflated to 4 atm of pressure for the duration of 30 seconds. In agreement with others [10], we believe that balloon inflation for 30 seconds at a pressure of 3 or 4 atm (corresponding to 2,280 and 3,040 mm Hg, respectively) is excessive and may cause AVB requiring PPM implantation. Although not currently supported by the manufacturer, an inflation pressure of 1.5 to 2 atm has been used consistently at our center since 2014 together with concomitant releasing of the commissural stay sutures (2010 to 2013: 205 patients, 40%; 2014 to 2017: 307 patients, 60%).…”

“…According to the instructions for use, the pressure equals 3,040 mm Hg when inflating the balloon with 4 atm. This may be the reason for PPM requirement, as also suggested by other investigators [10].…”

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

“…Further to consideration of prosthesis position is the fact that it is a successful balance between the outward force of the prosthesis and the opposing force of the aortic annulus, which maintains the position of a sutureless prosthesis with the avoidance of PVR. 39 The full clinical impact of PPM insertion after TAVI has been examined by a number of authors. Buellesfeld et al 40 determined that 12-month all-cause mortality was similar among patients with and without PPM implantation after TAVI (18% vs 22.9%).…”

Benefits of sutureless aortic valves may not be limited to reduced crossclamp time

“…I read the recent letter by Tavlasoglu and colleagues 1 with great interest. The benefits of minimally invasive surgery for conventional aortic valve replacement performed through a partial upper sternotomy or right minithoracotomy have been reported to include not only reduced ventilation time, decreased incisional pain, reduced wound infections, reduced blood loss and transfusions, and decreased time to discharge but also significantly reduced mortality.…”