Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jul 22:8:F1000 Faculty Rev-1159.
doi: 10.12688/f1000research.17995.1. eCollection 2019.

Recent advances in aortic valve replacement

Cristiano Spadaccio  1 , Khalid Alkhamees  2 , Nawwar Al-Attar  1
Affiliations
Review

Recent advances in aortic valve replacement

Cristiano Spadaccio et al. F1000Res. .

Abstract

Aortic valve replacement has stood the test of time but is no longer an operation that is exclusively approached through a median sternotomy using only sutured prostheses. Currently, surgical aortic valve replacement can be performed through a number of minimally invasive approaches employing conventional mechanical or bioprostheses as well as sutureless valves. In either case, the direct surgical access allows inspection of the valve, complete excision of the diseased leaflets, and debridement of the annulus in a controlled and thorough manner under visual control. It can be employed to treat aortic valve pathologies of all natures and aetiologies. When compared with transcatheter valves in patients with a high or intermediate preoperative predictive risk, conventional surgery has not been shown to be inferior to transcatheter valve implants. As our understanding of sutureless valves and their applicability to minimally invasive surgery advances, the invasiveness and trauma of surgery can be reduced and outcomes can improve. This warrants further comparative trials comparing sutureless and transcatheter valves.

Keywords: aortic valve; replacement; surgery.

PubMed Disclaimer

Conflict of interest statement

No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

References

    1. Nishimura RA, Otto CM, Bonow RO, et al. : 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):e521–643. 10.1161/CIR.0000000000000031 - DOI - PubMed

    2. F1000 Recommendation

    1. Fischlein T, Meuris B, Hakim-Meibodi K, et al. : The sutureless aortic valve at 1 year: A large multicenter cohort study. J Thorac Cardiovasc Surg. 2016;151(6):1617–1626.e4. 10.1016/j.jtcvs.2015.12.064 - DOI - PubMed

    2. F1000 Recommendation

    1. Leon MB, Smith CR, Mack MJ, et al. : Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. N Engl J Med. 2016;374(17):1609–20. 10.1056/NEJMoa1514616 - DOI - PubMed

    2. F1000 Recommendation

    1. Webb JG, Doshi D, Mack MJ, et al. : A Randomized Evaluation of the SAPIEN XT Transcatheter Heart Valve System in Patients With Aortic Stenosis Who Are Not Candidates for Surgery. JACC Cardiovasc Interv. 2015;8(14):1797–806. 10.1016/j.jcin.2015.08.017 - DOI - PubMed

    2. F1000 Recommendation

    1. Pibarot P, Dumesnil JG: Prosthetic heart valves: selection of the optimal prosthesis and long-term management. Circulation. 2009;119(7):1034–48. 10.1161/CIRCULATIONAHA.108.778886 - DOI - PubMed