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

D’Onofrio, Augusto; Messina, Antonio; Lorusso, Roberto; Alfieri, Ottavio; Fusari, Melissa; Rubino, Paolo; Rinaldi, Mauro; Bartolomeo, Roberto Di; Glauber, Mattia; Troise, Giovanni; Gerosa, Gino

doi:10.1016/j.jtcvs.2012.07.040

Cited by 107 publications

(91 citation statements)

References 25 publications

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“…15,16 Sutureless AVR is reported to be an effective option for high-risk patients and can reduce the occurrence of paravalvular leakage compared to transcatheter AVR (TAVR). 17, 18 Considering the significant advantages of RTAVR, sutureless RTAVR can be an effective alternative with broad indications. Although RTAVR was initially introduced for patients without preoperative risk factors, the indications have been expanding and it can be an effective option for high-risk patients, as well as TAVR.…”

Section: Risk Factors For Length Of Icu and Hospital Stay In Miavrmentioning

confidence: 99%

Propensity Score-Matched Analysis of Minimally Invasive Aortic Valve Replacement

Hiraoka

Totsugawa

Kurabayashi

et al. 2014

Circ J

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Section: Risk Factors For Length Of Icu and Hospital Stay In Miavrmentioning

confidence: 99%

Propensity Score-Matched Analysis of Minimally Invasive Aortic Valve Replacement

Hiraoka

Totsugawa

Kurabayashi

et al. 2014

Circ J

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“…Smith et al [8] studied short-term outcomes, while Kodali et al [28] focused on long-term outcomes of patients who underwent TAVR. We also found 17 cohort studies [9,10,11,12,13,14,15,16,17,18,19,20,21,22,30,31,32] (table 2), among which 3 cohort studies reported no AKI event; 2 studies reported no AKI event in the TAVR group [30,31], and 1 study reported no AKI event in the SAVR group [32]. …”

Section: Resultsmentioning

confidence: 88%

“…We included 3 RCTs [5,7,8] and 14 cohort studies [9,10,11,12,13,14,15,16,17,18,19,20,21,22] with a total of 4,965 patients in the meta-analysis to assess the risk of AKI in patients undergoing TAVR. Of 14 cohort studies, 8 studies [10,11,13,14,16,17,19,22] used propensity score analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, the evidence to support the renal protective effect of TAVR is still controversial. While some studies have demonstrated no significant reduction in AKI risk among symptomatic AS patients who underwent TAVR [7,8,9,10,11,12,13,14,15,16], several others showed higher incidence of postoperative AKI among patients who underwent TAVR compared with those who underwent SAVR [17,18], and conversely, other studies have reported that TAVR is an effective intervention to reduce the incidence of postoperative AKI [5,19,20,21,22]. …”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

et al. 2015

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Background: The objective of this meta-analysis was to evaluate the risk of acute kidney injury (AKI) in patients who underwent transcatheter aortic valve replacement (TAVR). Methods: A literature search was performed using MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and clinicaltrials.gov from inception through October, 2014. Studies that reported relative risks, ORs, or hazard ratios comparing the AKI risk in patients who underwent TAVR versus those who underwent surgical aortic valve replacement were included. We performed the pre-specified sensitivity analysis including only propensity score-based studies. Mortality risk was evaluated among the studies that reported AKI outcome. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Three randomized controlled trials (RCTs) with 1,852 patients and 14 cohort studies with 3,113 patients were analyzed to assess the AKI risk in patients undergoing TAVR. The pooled RRs of AKI in patients undergoing TAVR were 0.65 (95% CI 0.36-1.15, I² = 75%) in the analysis of RCTs and propensity score-based studies and 0.76 (95% CI 0.44-1.34, I² = 79%) in the analysis of observational studies. Sensitivity analysis in RCTs and propensity score-based studies using a standard AKI definition demonstrated a significant association between TAVR and lower AKI risk (RR 0.35, 95% CI 0.25-0.50, I² = 0%). Our meta-analyses of RCTs and propensity score-based studies did not find associations between TAVR and reduced risks of severe AKI requiring dialysis (RR 0.82, 95% CI 0.38-1.79, I² = 63%). Conclusions: Our meta-analysis demonstrates an association between TAVR and lower AKI risk.

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“…A propensity matched study between 519 patients having TAVR or sAVR using the Perceval S valve and then matched to 38 pairs has been presented by D'Onofrio. 21 Hemodynamic performance, complications, and pacemaker insertion rates were similar between the groups.…”

Section: Sutureless Valvesmentioning

confidence: 79%

Surgical Approaches to Aortic Valve Replacement and Repair—Insights and Challenges

Ramlawi

Ramchandani

Reardon

2011

Interventional Cardiology Review

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Since 1960, surgical aortic valve replacement (sAVR) had been the only effective treatment for symptomatic severe aortic stenosis until the recent development of transcatheter aortic valve replacement (TAVR). TAVR has offered an alternative, minimally invasive treatment approach particularly for patients whose age or co-morbidities make them unsuitable for sAVR. The rapid and enthusiastic utilization of this new technique has triggered some speculation about the imminent demise of sAVR. We believe that despite the recent advances in TAVR, surgical approach to aortic valve replacement has continued to develop and will continue to be highly relevant in the future.This article will discuss the recent developments and current approaches for sAVR, and how these approaches will keep pace with catheter-based technologies.

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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

Abstract: This preliminary experience showed that, in patients at high risk for conventional surgery, SU-AVR is as safe and effective as TA-TAVI and that it is associated with a lower rate of postprocedural paravalvular leak.

Cited by 107 publications

References 25 publications

Propensity Score-Matched Analysis of Minimally Invasive Aortic Valve Replacement

Propensity Score-Matched Analysis of Minimally Invasive Aortic Valve Replacement

Acute Kidney Injury after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Surgical Approaches to Aortic Valve Replacement and Repair—Insights and Challenges

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