Sutureless Aortic Valve Prosthesis in Redo Procedures: Single-Center Experience.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Devices

Background:

• Sutureless aortic valve prostheses offer favorable hemodynamics and minimally invasive options.
• A growing elderly population increases the need for aortic valve reoperation.
• Redo aortic valve surgery presents unique challenges.

Purpose of the Study:

• To evaluate the single-center experience with sutureless aortic valve replacement (SU-AVR) in patients undergoing reoperation.
• To assess the safety and efficacy of SU-AVR in a redo setting.

Main Methods:

• Retrospective analysis of 18 consecutive patients undergoing SU-AVR for reoperation (May 2020 - January 2023).
• Data collected included patient demographics, procedural times, and postoperative outcomes.

Main Results:

• Successful implantation in all patients with a moderate-risk profile (logistic EuroSCORE II median 7.8%).
• Mean cardiopulmonary bypass time: 103.3 min; cross-clamp time: 69.1 min.
• No permanent pacemaker implantation, low postoperative gradient (7.3 mmHg), and no paravalvular leakage. 30-day mortality was 11%.

Conclusions:

• SU-AVR simplifies redo aortic valve replacement procedures.
• Sutureless valves maximize effective orifice area, providing a safe and effective alternative to traditional prostheses and transcatheter valve-in-valve approaches in select cases.