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

Abstract

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.

Early and late outcomes of surgical aortic valve replacement with sutureless and rapid‐deployment valves versus transcatheter aortic valve implantation: Meta‐analysis with reconstructed time‐to‐event data of matched studies

“…After excluding duplicates and noneligible studies, ten studies [16][17][18][19][20][21][22][23][24][25] met our eligibility criteria (Figure 1). All studies were nonrandomized and observational, with two studies being prospective and four studies multicentric (Table 1).…”

“…Ten studies [16][17][18][19][20][21][22][23][24][25] reported their 30-day mortality rates (Table 5 and Figure S1). We observed that the pooled risk of 30-day mortality did not favor any groups (OR: 0.69; 95% CI: 0.31-1.53; p = 0.360).…”

“…S1. The data of 1322 patients (SURD-AVR: 661 patients; TAVI: 661 patients) from 6 studies [16][17][18][19]22,25 with a median follow-up of 17.6 months (interquartile range: 8.14-33.5 months) were pooled.…”

Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement

“…Surgical risk was estimated using the European System for Cardiac Operative Risk evaluation (EuroSCORE II) and the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score ( 11 , 12 ). The decision to use TAVR as the treatment modality was made by a multidisciplinary heart team, as previously reported ( 13 , 14 ). The transcatheter aortic valve type was chosen at the discretion of the operators based on the anatomical characteristics of the aortic valve, aortic root, and vascular access.…”

Comparing Clinical and Hemodynamic Parameters between the Two Aortic Valve Replacement in Patients with Severe Aortic Stenosis

“…Despite many advances in surgical techniques along with qualification of prosthetic valves, complications of valve replacement procedures such as infective endocarditis, dehiscence, paravalvular leak (PVL), abscess formation, aortic dissection, coronary artery occlusion, mediastinitis, brain stroke, heartbeat irregularity, and arrhythmias remains significant. [ 9 10 ] To reduce the mentioned surgical complications, several methods have been performed by heart surgeons. In the present study, the complications of AVR surgery have been compared between the two surgical techniques for AVR.…”