Surgical Sutureless and Transcatheter Aortic Valves

Kamperidis, Vasileios; Rosendael, Philippe J. van; Weger, Arend de; Katsanos, Spyridon; Regeer, Madelien V.; Kley, Frank van der; Mertens, Bart; Sianos, Georgios; Marsan, Nina Ajmone; Bax, Jeroen J.; Delgado, Victoria

doi:10.1016/j.jcin.2014.10.029

Cited by 42 publications

(16 citation statements)

References 29 publications

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“…In comparison to previous studies, our SURD-AVR cohort presented with more co-morbidities resulting in higher ES, as SURD-AVR has been predominantly chosen for patients with increased operative risk and need for concomitant procedures in our center. This may explain a slightly higher in-hospital mortality rate as compared to other reports [13,15,[17][18][19]. The Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR) data reported an overall hospital mortality of 2.1% with a logistic ES of 11.3 ± 9.7% in 3343 patients [25], which is markedly lower than in our SURD-AVR cohort.…”

Section: Discussioncontrasting

confidence: 70%

Are Sutureless and Rapid-Deployment Aortic Valves a Serious Alternative to TA-TAVI? A Matched-Pairs Analysis

Al-Maisary

Farag

Gussinklo

et al. 2021

JCM

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Background: Transcatheter aortic valve implantation is a feasible alternative to conventional aortic valve replacement with expanding indication extending to low-risk patients. Sutureless and rapid-deployment aortic valves were developed to decrease procedural risks in conventional treatment. This paired-match analysis aims to compare patients undergoing surgical transcatheter aortic valve implantation to sutureless and rapid-deployment aortic valve implantation. Methods: Retrospective database analysis between 2010 and 2016 revealed 214 patients undergoing transcatheter aortic valve implantation procedures through surgical access (predominantly transapical) and 62 sutureless and rapid-deployment aortic valve procedures including 26 patients in need of concomitant coronary artery bypass surgery. After matching, 52 pairs of patients were included and analyzed. Results: In-hospital death (5.8% vs. 3.8%; p = 0.308) was comparable between transcatheter aortic valve implantation (mean age 77 ± 4.3 years) and sutureless and rapid-deployment aortic valve implantation groups (mean age 75 ± 4.0 years), including 32 females in each group. The logistic EuroSCORE was similar (19 ± 12 vs. 17 ± 10; p = 0.257). Postoperative renal failure (p = 0.087) and cerebrovascular accidents (p = 0.315) were without significant difference. The incidence of complete heart block requiring permanent pacemaker treatment was relatively low for both groups (1.9% vs. 7.7%; p = 0.169) for TAVI and sutureless and rapid-deployment valves respectively. Intraoperative use of blood transfusion was higher in the sutureless and rapid-deployment aortic valve implantation group (0.72 U vs. 1.46 U, p = 0.014). Estimated survival calculated no significant difference between both groups after 6 months (transcatheter aortic valve implantation: 74 ± 8% vs. sutureless and rapid-deployment aortic valve implantation: 92 ± 5%; log rank p = 0.097). Conclusion: Since sutureless and rapid-deployment aortic valve implantation is as safe and effective as transapical transcatheter aortic valve implantation, combining the advantage of standard diseased-valve removal with shorter procedural times, sutureless and rapid-deployment aortic valve replacement may be considered as an alternative for patients with elevated operative risk considered to be in the “gray zone” between transcatheter aortic valve implantation and conventional surgery, especially if concomitant myocardial revascularization is required.

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Section: Discussioncontrasting

confidence: 70%

Are Sutureless and Rapid-Deployment Aortic Valves a Serious Alternative to TA-TAVI? A Matched-Pairs Analysis

Al-Maisary

Farag

Gussinklo

et al. 2021

JCM

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“…There were 7 11 , 13 , 26 , 31 , 33 , 34 , 7 11 , 13 , 26 , 31 , 33 , 34 and 8 11 , 21 , 22 , 26 , 31 , 33 , 34 studies recruiting 3,760, 3,760 and 4,057 patients that reported the incidences of overall, moderate and severe PPM after TAVR compared to SAVR respectively. TAVR had lower incidence of overall (OR, 0.33, 95% CI, 0.22 to 0.51, P < 0.001, I 2 = 81.4, egger’s = 0.09, Fig.…”

Section: Resultsmentioning

confidence: 99%

Incidence, Predictors and Outcome of Prosthesis-Patient Mismatch after Transcatheter Aortic Valve Replacement: a Systematic Review and Meta-analysis

Liao

et al. 2017

Sci Rep

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The aim of this study was to investigate the incidence, predictors and outcome of prosthesis-patient mismatch (PPM) following transcatheter aortic valve replacement (TAVR). A total of 30 articles incorporating 4,691 patients were identified. The pooled incidences of overall, moderate and severe PPM following TAVR were 33.0%, 25.0% and 11.0% respectively. Medtronic CoreValve (MCV) had lower incidence of overall (32% vs: 40%, P < 0.0001) and moderate (23% vs 32%, P < 0.0001) than Edwards Sapien (ESV). PPM was associated with a younger age, smaller annulus diameter and lower left ventricular ejection fraction in comparison with those patients without PPM. Post-dilation (OR, 0.51, 95% CI, 0.38 to 0.68, p < 0.001) during TAVR would decrease the incidence of PPM. Although PPM was common after TAVR, no significant differences were observed both in short- and mid-term all-cause mortality (30 day: OR: 1.1, 95% CI, 0.70 to 1.73 and 2 year: OR: 1.01, 95% CI, 0.74 to 1.38) between patients with PPM and those without PPM. In conclusion, despite being common after TAVR, the incidence of PPM was lower than that of surgical aortic valve replacement (SAVR) and decreased with the experience accumulating, and PPM was not seen to impact on short- and mid-term survival, regardless of its magnitude.

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“…Similar results were obtained from other studies comparing SAVR and TAVI. Regarding the prevalence shown in these papers [ 16 , 18 , 20 , 21 ], the prevalence of PPM with SAVR was fairly high (Fig. 1 ; diamonds) compared to the results obtained from paper about SAVR alone (Fig.…”

Section: Introductionmentioning

confidence: 68%

Aortic valve replacement and prosthesis-patient mismatch in the era of trans-catheter aortic valve implantation

Morita

2016

Gen Thorac Cardiovasc Surg

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ObjectiveThe treatment strategy for aortic stenosis (AS) has been changing due to newly developed valvular prostheses and trans-catheter aortic valve implantation (TAVI). To determine the role of new modalities for AS with a small aortic root, papers using the concept of prosthesis-patient mismatch (PPM) were reviewed.MethodsFirst, to determine the cut-off value of the indexed effective orifice area (IEOA) for defining PPM, the studies of surgical aortic valve replacement (SAVR) with a follow-up longer than 5 years and a patient number larger than 500 were reviewed. Second, the papers comparing TAVI and SAVR were reviewed. Furthermore, the prevalence of PPM was reviewed, with the addition of papers on aortic root enlargement, sutureless AVR, and aortic valve reconstruction with autologous pericardium.Results and conclusionThe results of the long-term survival after aortic valve replacement (AVR) have indicated that an IEOA less than 0.65 cm2/m2 should be avoided in all cases, whereas the indications for patients with an IEOA between 065 and 0.85 cm2/m2 should be determined by considering multiple factors. A large body size and younger age have a significantly negative influence on the long-term survival. In Asian population, the prevalence of PPM was low, despite the fact that the size of the aortic annulus was small. The IEOA after TAVI was larger than after surgical AVR in population-matched studies. To evaluate the role of TAVI and other modalities for a small aortic root, studies with a longer follow-up and larger volume are thus warranted.

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Surgical Sutureless and Transcatheter Aortic Valves

Abstract: TAVR prostheses demonstrated better hemodynamics than the 3f Enable valve but a higher incidence of aortic regurgitation. However, these differences did not influence mid-term survival of patients.

Cited by 42 publications

References 29 publications

Are Sutureless and Rapid-Deployment Aortic Valves a Serious Alternative to TA-TAVI? A Matched-Pairs Analysis

Are Sutureless and Rapid-Deployment Aortic Valves a Serious Alternative to TA-TAVI? A Matched-Pairs Analysis

Incidence, Predictors and Outcome of Prosthesis-Patient Mismatch after Transcatheter Aortic Valve Replacement: a Systematic Review and Meta-analysis

Aortic valve replacement and prosthesis-patient mismatch in the era of trans-catheter aortic valve implantation

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