A Meta-Analysis Examining Differences in Short-Term Outcomes between Sutureless and Conventional Aortic Valve Prostheses. Issue 6 (November 2015)

• Record Type: Journal Article
• Authors: Hurley, Eoghan T.; O'Sullivan, Katie E.; Segurado, Ricardo; Hurley, John P.
• Is Part Of: Innovations. Volume 10:Issue 6(2015:Nov./Dec.)
• Page Start: 375
• Page End: 382
• Publication Date: 2015-11
• Subjects: Aortic stenosis -- Pacemaker -- Sutureless aortic valve -- Valve replacement; Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1097/imi.0000000000000221
• Languages: English
• ISSNs: 1556-9845

Abstract

Objective: Sutureless aortic valve prostheses are anchored by radial force in a mechanism similar to that of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is associated with an increased permanent pacemaker (PPM) requirement in a significant proportion of patients. We undertook a meta-analysis to examine the incidence of PPM insertion associated with sutureless compared with conventional surgical aortic valve replacement. Methods: A systematic review was conducted in accordance with the Prisma guidelines. 1 All searches were performed on August 10, 2014. Studies between 2007 and 2014 were included in the search. Results: A total of 832 patients were included in the sutureless group and 3, 740 in the conventional group. Aortic cross-clamp (39.8 vs 62.4 minutes; P < 0.001) and cardiopulmonary bypass (64.9 vs 86.7 minutes; P = 0.002) times were shorter in the sutureless group. Permanent pacemaker implantation rate was higher in the sutureless cohort (9.1% vs 2.4%; P = 0.025). Conclusions: Sutureless aortic valve prostheses are associated with significantly shorter cardiopulmonary bypass and aortic cross-clamp times and a higher incidence of PPM insertion than conventional. Further investigation of the prognostic significance is required.