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Sutureless Aortic Valve Replacement.

Kenan Sever1, Oguz Konukoglu1, Ozgur Yildirim1

  • 1Department of Cardiovascular Surgery, Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital, Istanbul, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|July 29, 2021
PubMed
Summary
This summary is machine-generated.

Sutureless aortic valve replacement (AVR) offers shorter cross-clamp and cardiopulmonary bypass times with improved postoperative aortic gradients compared to conventional AVR. However, no significant differences were observed in mortality or hospital stay between the two methods.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Technology

Background:

  • Severe symptomatic aortic valve disease necessitates intervention.
  • Conventional aortic valve replacement (AVR) involves significant procedural times.
  • Sutureless AVR aims to reduce surgical invasiveness and duration.

Purpose of the Study:

  • To compare the clinical and echocardiographic outcomes of sutureless AVR with conventional AVR.
  • To evaluate the efficacy and safety of sutureless valve technology.

Main Methods:

  • A case-control study was conducted between December 2014 and December 2019.
  • Ninety-one patients (49 sutureless, 42 conventional) with severe symptomatic aortic valve disease (NYHA class II or higher, age >55) were enrolled.
  • Perioperative data, including cross-clamp time, cardiopulmonary bypass (CPB) duration, pressure gradients, paravalvular leak, pacemaker requirement, ICU stay, hospital stay, and mortality, were assessed.

Main Results:

  • Sutureless AVR demonstrated significantly shorter mean cross-clamp (72.86 vs. 104.96 min) and CPB times (91.88 vs. 119.81 min).
  • Postoperative aortic pressure gradients were lower in the sutureless group (16/9 mmHg vs. 24/12 mmHg).
  • No significant differences were found in paravalvular leak rates, permanent pacemaker requirements, ICU/hospital stay, or 30-day mortality between the groups.

Conclusions:

  • Sutureless AVR provides advantages in reduced cross-clamp and CPB times and improved postoperative aortic gradients.
  • The benefits of sutureless AVR may be more pronounced in complex cases or minimally invasive procedures.
  • Further research is warranted to fully elucidate the long-term outcomes and optimal patient selection for sutureless AVR.