Long-term outcomes of sutureless and rapid-deployment aortic valve replacement: a systematic review and meta-analysis

Williams, Michael L.; Flynn, Campbell D.; Mamo, Andrew; Tian, David H.; Kappert, Utz; Wilbring, Manuel; Folliguet, Thierry; Fiore, Antonio; Miceli, Antonio; D’Onofrio, Augusto; Cibin, Giorgia; Gerosa, Gino; Glauber, Mattia; Fischlein, Theodor; Pollari, Francesco

doi:10.21037/acs-2020-surd-25

Cited by 29 publications

(32 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…SBs have demonstrated in large series and multicenter studies that they provide satisfactory results with low operative mortality, constantly improving outcomes, even when associated procedures are performed, and promising medium-term data [ 30 , 31 , 32 ]. Similar results have been reported with RDBs with regard to safety, hemodynamic performance, and favorable outcomes [ 33 , 34 , 35 , 36 ]. Based on the currently available data, both SBs and RDBs are considered valid alternatives to conventional prostheses for AVR.…”

Section: Discussionsupporting

confidence: 84%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

View full text Add to dashboard Cite

Sutureless and rapid-deployment bioprostheses have been introduced as alternatives to traditional prosthetic valves to reduce cardiopulmonary and aortic cross-clamp times during aortic valve replacement. These devices have also been employed in extremely demanding surgical settings, as underlined in the present review. Searches on the PubMed and Medline databases aimed to identify, from the English-language literature, the reported cases where both sutureless and rapid-deployment prostheses were employed in challenging surgical situations, usually complex reoperations sometimes even performed as bailout procedures. We have identified 25 patients for whom a sutureless or rapid-deployment prosthesis was used in complex redo procedures: 17 patients with a failing stentless bioprosthesis, 6 patients with a failing homograft, and 2 patients with the failure of a valve-sparing procedure. All patients survived reoperation and were reported to be alive 3 months to 4 years postoperatively. Sutureless and rapid-deployment bioprostheses have proved effective in replacing degenerated stentless bioprostheses and homografts in challenging redo procedures. In these settings, they should be considered as a valid alternative not only to traditional prostheses but also in selected cases to transcatheter valve-in-valve solutions.

show abstract

Section: Discussionsupporting

confidence: 84%

Use of Sutureless and Rapid Deployment Prostheses in Challenging Reoperations

Vendramin

Lechiancole

Piani

et al. 2021

JCDD

View full text Add to dashboard Cite

show abstract

“…Severe AS is also seen as a disease that is affected by nutritional status because it is common in the elderly, and long‐term outcomes of these patients are also the effect of malnutrition. Moreover, SAVR with sutureless/rapid‐deployment (SRD) prostheses could be useful especially in frailty 29 . However, Erfe et al 30 indicated that in SRD implantation, short‐term mortality, major comorbidities, and perivalvular regurgitation were similar between SRD and traditional stented bioprosthetic patients.…”

Section: Discussionmentioning

confidence: 99%

Prognostic influence of objective nutritional indexes on mortality after surgical aortic valve replacement in elderly patients with severe aortic stenosis (from the nutrition‐SAVR trial)

et al. 2021

View full text Add to dashboard Cite

Aim Several scoring systems, such as controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI), have been previously described to show nutritional status. In the present study, we aimed to investigate the value of these scoring systems in predicting in‐hospital and long‐term mortality in patients undergoing surgical aortic valve replacement (SAVR). Methods PNI, GNRI, and CONUT were determined using the receiver operator characteristics curve analysis in 150 consecutive elderly patients (age: 70 (66–74) years, male: 78) who underwent SAVR due to degenerative severe aortic stenosis (AS). Patients were divided into two groups according to cutoff values from these indexes. Results During the 50 ± 31 months follow‐up period, a total of 36 (24%) patients died. 30‐day mortality, 1‐year mortality, and total mortality were significantly higher in lower PNI, lower GNRI, and higher CONUT groups. PNI cutoff value was 49.2, GNRI cutoff value was 102.5, and CONUT cutoff value was 1.5. PNI ≤ 49.2, GNRI ≤ 102.5, and CONUT > 1.5 values were found to be independent predictors of total mortality even after risk adjustment. In addition, in the mortality group, PNI (53.7 ± 5.9 vs. 47.4 ± 6.3; p < .001) and GNRI (108 ± 10 vs. 99 ± 6.3); p < .001) were significantly lower, while CONUT score (1 [0–2] vs. 2 [0.2–3]; p < .001) was significantly higher. Conclusion Objective nutritional indexes including CONUT score, PNI, and GNRI are important prognostic factors and those indexes should be part of frailty assessment in patients with severe AS.

show abstract

“…4 The completeness of the presented data gives robustness to the very low 5-year incidence of major adverse cardiac and cerebrovascular events compared with previous analyses, with a particular focus on structural valve deterioration and reintervention. 5 But that's not all. This sponsored trial can also be considered a good reference point for benchmarking the surgical arm in the TAVI versus SAVR trials.…”

mentioning

confidence: 99%