Sutureless aortic valve replacement as an alternative treatment for patients belonging to the “gray zone” between transcatheter aortic valve implantation and conventional surgery: A propensity-matched, multicenter analysis (original) (raw)
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Non-Inferiority of Sutureless Aortic Valve Replacement in the TAVR Era: David versus Goliath
Life
Background: The rapid development of transcatheter treatment methods has made transcatheter aortic valve replacement (TAVR) a feasible alternative to conventional surgical aortic valve replacement (SAVR). Recently, indications for TAVR have been expanded to intermediate- and low-risk patients, although there still remains a portion of ineligible patients. We sought to evaluate and compare our experience with sutureless SAVR and transapical TAVR in the “grey-area” of patients unsuitable for transfemoral access. Methods: Between April 2018 and June 2021, 248 consecutive patients underwent a sutureless SAVR (SU-SAVR) or TA-TAVR at our institution. We performed a pair-matched analysis and identified 56 patient pairs based on the EuroSCORE II. All transcatheter procedures were performed using SAPIEN XT/3™ prostheses, while all surgical procedures deployed the Perceval (LivaNova) aortic valve. Results: All patients presented with multiple comorbidities as reflected by the median EuroSCORE...
Journal of Clinical Medicine
Background: Recent trials showed that TAVI is neither inferior nor superior to surgical aortic valve replacement. The aim of this study was to evaluate the outcomes of Sutureless and Rapid Deployment Valves (SuRD-AVR) when compared to TAVI in low surgical risk patients with isolated aortic stenosis. Methods: Data from five European Centers were retrospectively collected. We included 1306 consecutive patients at low surgical risk (EUROSCORE II < 4) who underwent aortic valve replacement by means of SuRD-AVR (n = 636) or TAVI (n = 670) from 2014 to 2019. A 1:1 nearest-neighbor propensity-score was performed, and two balanced groups of 346 patients each were obtained. The primary endpoints of the study were: 30-day mortality and 5-year overall survival. The secondary endpoint was 5-year survival freedom from major adverse cardiovascular and cerebrovascular events (MACCEs). Results: Thirty-day mortality was similar between the two groups (SuRD-AVR:1.7%, TAVI:2.0%, p = 0.779), while t...
Sutureless Aortic Valve Replacement: Does It Make Sense?
2020
BACKGROUND Aortic valve stenosis is the most common valve disease in the elderly. Sutureless aortic valve replacement has been introduced as an alternative to conventional AVR in elderly high-risk patients. The aim of this study is reporting our single-center experience regarding early outcomes. METHODS Between December 2014 and December 2019, 91 patients (45 Women, 46 Males) were undergone aortic valve replacement in our clinic (49 Sutureless, 42 conventional). Perioperative clinical and echocardiographic outcomes were assessed in all patients. RESULTS The average age was 73.08±7.53 and 66.26±8.63 for sutureless and conventional groups. The mean cross-clamp time and the cardio- pulmonary bypass (CPB) time were 72.86 and 91.88 min, and 104.96 and 119.81 min, respectively. In sutureless group, 30 (61.2%) patients underwent additional procedures. These were CABG, mitral interventions, tricuspid repair, ascending aortic surgery and myxoma. Preoperative peak and mean pressure gradients ...