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A Meta-Analysis Examining Differences in Short-Term Outcomes Between Sutureless and Conventional Aortic Valve
Eoghan T Hurley1, Katie E O'Sullivan, Ricardo Segurado
1From the *The Heart Team, Mater Private Hospital, Dublin, Ireland; and †CSTAR Centre for Statistical Training and Research, University College, Dublin, Ireland.
Innovations (Philadelphia, Pa.)
|December 23, 2015
Summary
Sutureless aortic valve replacement offers shorter procedure times but has a higher rate of permanent pacemaker (PPM) insertion compared to conventional methods. Further research is needed to understand the long-term implications of this increased PPM requirement.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Interventional Cardiology
Background:
- Sutureless aortic valve prostheses utilize radial force for anchoring, similar to transcatheter aortic valve implantation.
- Transcatheter aortic valve implantation is linked to a notable increase in permanent pacemaker (PPM) requirements.
- A comparison between sutureless and conventional surgical aortic valve replacement regarding PPM incidence is warranted.
Purpose of the Study:
- To conduct a meta-analysis comparing the incidence of permanent pacemaker (PPM) insertion in patients undergoing sutureless aortic valve replacement versus conventional surgical aortic valve replacement.
Main Methods:
- A systematic review adhering to Prisma guidelines was performed.
- Literature searches were conducted up to August 10, 2014.
- Studies published between 2007 and 2014 were included.
Main Results:
- The analysis included 832 patients in the sutureless group and 3,740 in the conventional group.
- Shorter aortic cross-clamp (39.8 vs 62.4 minutes) and cardiopulmonary bypass (64.9 vs 86.7 minutes) times were observed in the sutureless group (P < 0.001 and P = 0.002, respectively).
- The rate of permanent pacemaker implantation was significantly higher in the sutureless cohort (9.1% vs 2.4%; P = 0.025).
Conclusions:
- Sutureless aortic valve prostheses are associated with significantly reduced cardiopulmonary bypass and aortic cross-clamp times.
- A higher incidence of permanent pacemaker insertion is observed with sutureless aortic valve prostheses compared to conventional methods.
- Further investigation into the prognostic significance of the increased PPM incidence with sutureless valves is necessary.
