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

Phan, Kevin; Tsai, Yi-Chin; Niranjan, Nithya; Bouchard, Denis; Carrel, Thierry; Dapunt, Otto E; Eichstaedt, Harald C; Fischlein, Theodor; Gersak, Borut; Glauber, Mattia; Haverich, Axel; Misfeld, Martin; Oberwalder, Peter J; Santarpino, Giuseppe; Shrestha, Malakh Lal; Solinas, Marco; Vola, Marco; Yan, Tristan D; Di Eusanio, Marco (2015). Sutureless aortic valve replacement: a systematic review and meta-analysis. Annals of cardiothoracic surgery, 4(2), pp. 100-111. AME Publishing Company 10.3978/j.issn.2225-319X.2014.06.01

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BACKGROUND Sutureless aortic valve replacement (SU-AVR) has emerged as an innovative alternative for treatment of aortic stenosis. By avoiding the placement of sutures, this approach aims to reduce cross-clamp and cardiopulmonary bypass (CPB) duration and thereby improve surgical outcomes and facilitate a minimally invasive approach suitable for higher risk patients. The present systematic review and meta-analysis aims to assess the safety and efficacy of SU-AVR approach in the current literature. METHODS Electronic searches were performed using six databases from their inception to January 2014. Relevant studies utilizing sutureless valves for aortic valve implantation were identified. Data were extracted and analyzed according to predefined clinical endpoints. RESULTS Twelve studies were identified for inclusion of qualitative and quantitative analyses, all of which were observational reports. The minimally invasive approach was used in 40.4% of included patients, while 22.8% underwent concomitant coronary bypass surgery. Pooled cross-clamp and CPB duration for isolated AVR was 56.7 and 46.5 minutes, respectively. Pooled 30-day and 1-year mortality rates were 2.1% and 4.9%, respectively, while the incidences of strokes (1.5%), valve degenerations (0.4%) and paravalvular leaks (PVL) (3.0%) were acceptable. CONCLUSIONS The evaluation of current observational evidence suggests that sutureless aortic valve implantation is a safe procedure associated with shorter cross-clamp and CPB duration, and comparable complication rates to the conventional approach in the short-term.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2225-319X

Publisher:

AME Publishing Company

Language:

English

Submitter:

Daniela Huber

Date Deposited:

03 Feb 2016 13:40

Last Modified:

11 Nov 2016 10:54

Publisher DOI:

10.3978/j.issn.2225-319X.2014.06.01

PubMed ID:

25870805

Uncontrolled Keywords:

Sutureless; aortic valve replacement (AVR); meta-analysis; minimally invasive

BORIS DOI:

10.7892/boris.75021

URI:

https://boris.unibe.ch/id/eprint/75021

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