Transcatheter aortic valve implantation (TAVI) versus sutureless aortic valve replacement (SUAVR) for aortic stenosis: a systematic review and meta-analysis of matched studies

Wang, Nelson; Tsai, Yi Chin; Niles, Natasha; Tchantchaleishvili, Vakhtang; Eusanio, Marco Di; Yan, Tristan D.; Phan, Kevin

doi:10.21037/jtd.2016.11.100

Cited by 28 publications

(20 citation statements)

References 44 publications

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“…Several meta-analyses reported higher postprocedural or 30-day mortality rates with TAVR group than with SU-AVR. 13 20 21 Similarly, in the present study, the TAVR group showed a trend towards a higher 30-day mortality than the SU-AVR group. However, there was no difference in cardiovascular mortality.…”

Section: Discussionsupporting

confidence: 80%

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Transcatheter Aortic Valve Replacement versus Sutureless Aortic Valve Replacement: A Single Center Retrospective Cohort Study

Chung

Lee

et al. 2021

Yonsei Med J

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Purpose This study sought to compare clinical outcomes between transcatheter aortic valve replacement (TAVR) and sutureless aortic valve replacement (SU-AVR). Materials and Methods In total, 320 patients with symptomatic severe aortic stenosis who underwent TAVR (n=254) or SU-AVR (n=66) at Severance Cardiovascular Hospital between July 2011 and September 2019 were included for analysis. Propensity score matching and inverse probability weighted adjustment were performed to adjust for confounding baseline characteristics. Outcomes defined by the Valve Academic Research Consortium-2 in 62 patients pairs were compared. Results Device success (79.0% vs. 79.0%, p >0.999) and 30-day mortality (4.8% vs. 0.0%, p =0.244) did not differ between the TAVR and SU-AVR groups. The TAVR group developed more frequent mild or moderate paravalvular leakage (59.7% vs. 8.1%, p <0.001), whereas SU-AVR was associated with higher rates of major or life-threatening bleeding (9.7% vs. 22.6%, p =0.040), acute kidney injury (8.1% vs. 21.0%, p =0.041), and new-onset atrial fibrillation (4.8% vs. 32.3%. p <0.001) at 30 days, along with longer stays in the intensive care unit (ICU) (1.9±1.6 days vs. 5.9±9.2 days, p =0.009) and hospital (7.1±7.9 days vs. 13.1±8.8 days, p <0.001). The TAVR group showed a trend towards a higher 1-year all-cause mortality, compared with the SU-AVR group (7.0% vs 1.7%, p =0.149). Cardiovascular mortality, however, did not differ significantly (1.6% vs 1.7%, p =0.960). Conclusion TAVR achieved a similar 1-year survival rate free from cardiovascular mortality as SU-AVR and was associated with a lower incidence of complications, except for paravalvular leakage, and shorter stays in the ICU and hospital.

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Section: Discussionsupporting

confidence: 80%

“… 4 Furthermore, few studies have directly compared TAVR versus SU-AVR for severe AS. 13 Therefore, this study sought to compare early and late outcomes of TAVR versus SU-AVR for symptomatic severe AS in a single-center cohort.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement versus Sutureless Aortic Valve Replacement: A Single Center Retrospective Cohort Study

Chung

Lee

et al. 2021

Yonsei Med J

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“…Rates of AI have remained, however, between 2.2-10.3% (38)(39)(40)(41)(42). The use of a sutureless prosthesis via a surgical approach has not resulted in an increased incidence of postoperative AI, with rates remaining under 1% (43). The ability to surgically resect the diseased valve leaflets and decalcify the aortic annulus prior to insertion of a prosthetic valve may be a critical factor in ensuring low rates of AI.…”

Section: Tavi Large Randomized Trials Comparing Tavi To Savrmentioning

confidence: 99%

Minimally-invasive versus transcatheter aortic valve implantation: systematic review with meta-analysis of propensity-matched studies

Doyle

Woldendorp

et al. 2021

J Thorac Dis

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Background: Minimally invasive aortic valve replacement (MiAVR) and transcatheter aortic valve implantation (TAVI) provide aortic valve replacement (AVR) by less invasive methods than conventional surgical AVR, by avoiding complete sternotomy. This study directly compares and analyses the available evidence for early outcomes between these two AVR methods. Methods: Electronic databases were searched from inception until August 2019 for studies comparing MiAVR to TAVI, according to predefined search criteria. Propensity-matched studies with sufficient data were included in a meta-analysis. Results: Eight studies with 9,744 patients were included in the quantitative analysis. Analysis of riskmatched patients showed no difference in early mortality (RR 0.76, 95% CI, 0.37-1.54, P=0.44). MiAVR had a signal towards lower rate of postoperative stroke, although this did not reach statistical significance (OR 0.42, 95% CI, 0.13-1.29, P=0.13). MiAVR had significantly lower rates of new pacemaker (PPM) requirement (OR 0.29, 95% CI, 0.16-0.52, P<0.0001) and postoperative aortic insufficiency (AI) or paravalvular leak (PVL) (OR 0.05, 95% CI, 0.01-0.20, P<0.0001) compared to TAVI, (OR 0.42, 95% CI, 0.13-1.29, P=0.13), while acute kidney injury (AKI) was higher in MiAVR compared to TAVI (11.1% vs. 5.2%, OR 2.28, 95% CI, 1.25-4.16, P=0.007). Conclusions: In patients of equivalent surgical risk scores, MiAVR may be performed with lower rates of postoperative PPM requirement and AI/PVL, higher rates of AKI and no statistical difference in postoperative stroke or short-term mortality, compared to TAVI. Further prospective trials are needed to validate these results.

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“…A number of studies have shown significantly higher rates of permanent pacemaker implantation with TAVI compared to sutureless AVR with the Perceval (14,26). However, these findings have not been reproduced consistently, and recently published systematic reviews and meta-analyses suggest that there is no significant difference in the rate of permanent pacemaker implantation between these technologies (9,27). These findings should be interpreted in light of the fact that self-expanding TAVI devices are associated with higher rates of conduction disorders than balloonexpandable devices (28).…”

Section: Sutureless Avr Versus Tavimentioning

confidence: 99%

Ten-year experience with the Perceval S sutureless prosthesis: lessons learned and future perspectives

2018

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Aortic stenosis has traditionally been addressed with surgical aortic valve replacement (AVR). In recent years, several technologies have emerged as alternative treatment methods for aortic valve disease. Among them, the Perceval (LivaNova, London, UK) is a sutureless valve that has been used in clinical practice for over 10 years. It has been implanted in over 20,000 patients worldwide. With nearly 600 Perceval implants since 2011, the Montreal Heart Institute has developed a worldwide expertise with this technology. In this article, we provide an overview of the clinical data currently available in the literature and discuss the lessons we have learned from our experience with the Perceval prosthesis.

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Transcatheter aortic valve implantation (TAVI) versus sutureless aortic valve replacement (SUAVR) for aortic stenosis: a systematic review and meta-analysis of matched studies

Abstract: The present study supports the use of minimally invasive SUAVR as an alternative to TAVI in high risk patients requiring aortic replacement. The presented results require further validation in prospective, randomized controlled studies.

Cited by 28 publications

References 44 publications

Transcatheter Aortic Valve Replacement versus Sutureless Aortic Valve Replacement: A Single Center Retrospective Cohort Study

Transcatheter Aortic Valve Replacement versus Sutureless Aortic Valve Replacement: A Single Center Retrospective Cohort Study

Minimally-invasive versus transcatheter aortic valve implantation: systematic review with meta-analysis of propensity-matched studies

Ten-year experience with the Perceval S sutureless prosthesis: lessons learned and future perspectives

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