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. 2022 Jul 11;62(2):ezac378.
doi: 10.1093/ejcts/ezac378.

Sutureless and rapid deployment versus sutured aortic valve replacement: a propensity-matched comparison from the Sutureless and Rapid Deployment International Registry

Paolo Berretta  1 , Martin Andreas  2 , Bart Meuris  3 , Tom Langenaeken  3 , Marco Solinas  4 , Giovanni Concistrè  4 , Utz Kappert  5 , Sebastian Arzt  5 , Giuseppe Santarpino  6   7   8 , Anna Nicoletti  7 , Martin Misfeld  9   10   11   12   13 , Michael A Borger  9 , Carlo Savini  14 , Gregorio Gliozzi  14 , Alberto Albertini  15 , Elisa Mikus  15 , Theodor Fischlein  8 , Jurij Kalisnik  8 , Gian Luca Martinelli  16 , Attilio Cotroneo  16 , Carmelo Mignosa  17 , Alessandro Ricasoli  17 , Tristan Yan  10   18 , Ghunter Laufer  2 , Marco Di Eusanio  1   18
Affiliations

Sutureless and rapid deployment versus sutured aortic valve replacement: a propensity-matched comparison from the Sutureless and Rapid Deployment International Registry

Paolo Berretta et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: To compare procedural and in-hospital outcomes of patients undergoing sutureless (Perceval, Livanova PLC, London, UK) and rapid deployment (Intuity Elite, Edwards Lifesciences, Irvine, CA, USA) aortic valve replacement (group 1) versus sutured aortic valve replacement (group 2).

Methods: Patients receiving isolated aortic valve replacement between 2014 and 2020 were analysed using data from the Sutureless and Rapid Deployment International Registry. Patients in group 1 and group 2 were propensity-score matched in a 1:1 ratio.

Results: A total of 7708 patients were included in the study. After matching, 2 groups of 2643 each were created. Patients in group 1 were more likely to undergo minimally invasive approaches and were associated with shorter operative times when compared with group 2. Overall in-hospital mortality was similar between groups. While an increased risk of stroke was observed in group 1 in the first study period (2014-2016; relative risk 3.76, P < 0.001), no difference was found in more recent year period (relative risk 1.66, P = 0.08; P for heterogeneity 0.003). Group 1 was associated with reduced rates of postoperative low cardiac output syndrome, atrial fibrillation and mild aortic regurgitation. New pacemaker implant was three-fold higher in group 1.

Conclusions: Our findings showed significant differences in procedural and clinical outcomes between the study groups. These results suggest that sutureless and rapid deployment aortic valve replacement should be considered as part of a comprehensive valve programme. The knowledge of the respective post-aortic valve replacement benefits for different valve technologies may result in patient-tailored valve selection with improved clinical outcomes.

Keywords: Aortic valve replacement; Rapid deployment valve; Sutureless and Rapid Deployment International Registry; Sutureless valve.

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