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Sutureless aortic valve replacement: a systematic review and meta-analysis.

Kevin Phan1, Yi-Chin Tsai1, Nithya Niranjan1

  • 11 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, The Prince Charles Hospital, Chermside, Australia ; 3 Montreal Heart Institute, Montréal, Canada ; 4 Hopital Universitaire de Berne, Berne, Switzerland ; 5 University Hospital Graz, Graz, Austria ; 6 European Medical School Oldenburg-Groningen, Klinikum Oldenburg, Oldenburg, Germany ; 7 Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany ; 8 University Medical Center Ljubljana, Ljubljana, Slovenia ; 9 Pasquinucci Heart Hospital, Massa, Italy ; 10 Hannover Medical School, Hannover, Germany ; 11 University of Leipzig, Leipzig, Germany ; 12 Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France ; 13 Cardiovascular Surgery Department, Sant'Orsola-Malpighi Hospital, Bologna University, Bologna, Italy.

Annals of Cardiothoracic Surgery
|April 15, 2015
PubMed
Summary

Sutureless aortic valve replacement (SU-AVR) offers a safe alternative for aortic stenosis, reducing procedure times and showing acceptable short-term outcomes. This minimally invasive approach is suitable for high-risk patients.

Keywords:
Suturelessaortic valve replacement (AVR)meta-analysisminimally invasive

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Interventional Cardiology

Background:

  • Sutureless aortic valve replacement (SU-AVR) is an innovative technique for aortic stenosis treatment.
  • It aims to shorten cross-clamp and cardiopulmonary bypass (CPB) times, facilitating minimally invasive surgery for high-risk patients.

Purpose of the Study:

  • To systematically review and meta-analyze the safety and efficacy of the SU-AVR approach.
  • To assess current literature on sutureless aortic valve implantation outcomes.

Main Methods:

  • Systematic review and meta-analysis of electronic searches across six databases up to January 2014.
  • Inclusion of studies reporting on sutureless valve implantation, with data extraction for clinical endpoints.

Main Results:

  • Twelve observational studies were analyzed, with 40.4% of patients undergoing minimally invasive procedures.
  • Pooled cross-clamp and CPB times were 56.7 and 46.5 minutes, respectively.
  • Acceptable short-term outcomes included 30-day mortality (2.1%), 1-year mortality (4.9%), stroke (1.5%), valve degeneration (0.4%), and paravalvular leak (3.0%).

Conclusions:

  • Sutureless aortic valve implantation is a safe procedure based on current observational data.
  • It is associated with reduced cross-clamp and CPB durations.
  • Complication rates appear comparable to conventional aortic valve replacement in the short term.