Conventional surgery, sutureless valves, and transapical aortic valve replacement: What is the best option for patients with aortic valve stenosis? A multicenter, propensity-matched analysis

Abstract

SAVR was associated with lower 30-day mortality than TA-TAVR. SAVR was also associated with a lower risk of postoperative aortic regurgitation compared with TA-TAVR. We did not find other significant differences in outcomes among matched patients treated with SAVR, SU-AVR, and TA-TAVR.

International Expert Consensus on Sutureless and Rapid Deployment Valves in Aortic Valve Replacement Using Minimally Invasive Approaches

“…A recent systematic review and meta-analysis on 12 studies using Perceval Sutureless valve, Medtronic 3F Enable, or EDWARDS INTUITY confirmed that sutureless aortic valve implantation is a safe procedure associated with shorter cross-clamp and cardiopulmonary bypass time compared to conventional approaches 21. Sutureless and rapid deployment aortic valve replacement, furthermore, was associated with lower 30-day mortality and lower risk of postoperative aortic regurgitation compared to transapical TAVI in a multicenter, propensity-matched analysis22 and improved survival up to 24 months23 compared to TAVI, respectively. Compared to the implantation of stented valves, the use of Perceval sutureless valve in retrospective analyses resulted in shorter procedural times24 associated with better clinical outcomes as measured by blood transfusions, shorter intensive care unit stay, ventilation time, postoperative atrial fibrillation, pleural effusions, respectively, and reduced hospital costs by approximately 25% 25…”

Aortic Valve Replacement Through Right Anterior Minithoracotomy: Can Sutureless Technology Improve Clinical Outcomes?

“…Transcatheter technology has been intensively studied since 2002 and has evolved now into a new sutureless surgical prosthesis idea. Sutureless alternative to the conventional (sutured) biological valves has been in clinical use since 2008 [9][10][11][12], and has been associated with good clinical and hemodynamic outcomes [13][14][15][16][17][18][19][20]. Excellent outcomes have been demonstrated with sutureless AVR in minimally invasive surgical setting [21][22][23][24], however without direct comparison with conventional prostheses.…”

The 3f Enable sutureless bioprosthesis: Early results, safeguards, and pitfalls

“…Recent studies comparing TAVI with sutureless prostheses highlight the higher rate of periprosthetic leakage in the TAVI group, along with a higher mortality rate in the transcatheter group. 8,9 We recommend the sutureless aortic prosthesis as the first choice of treatment for patients with a high surgical risk within the intermediate or grey area between TAVI and conventional surgery.…”