Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes
Abstract Objective This retrospective study aimed to compare the outcomes of sutureless aortic valve replacement (su-AVR) and conventional bioprosthetic sutured AVR (cAVR) in high-risk patients undergoing redo surgery. Methods A total of 79 patients who underwent redo AVR between 2014 and 2021 were...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03652-7 |
| _version_ | 1797363684438179840 |
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| author | Ian Cummings M Yousuf Salmasi Halil Ibrahim Bulut Alicja Zientara Mahmoud AlShiekh George Asimakopoulos |
| author_facet | Ian Cummings M Yousuf Salmasi Halil Ibrahim Bulut Alicja Zientara Mahmoud AlShiekh George Asimakopoulos |
| author_sort | Ian Cummings |
| collection | DOAJ |
| description | Abstract Objective This retrospective study aimed to compare the outcomes of sutureless aortic valve replacement (su-AVR) and conventional bioprosthetic sutured AVR (cAVR) in high-risk patients undergoing redo surgery. Methods A total of 79 patients who underwent redo AVR between 2014 and 2021 were included in the study. Of these, 27 patients underwent su-AVR and 52 underwent cAVR. Patient characteristics and clinical outcomes were analysed using multivariate regression and Kaplan Meier survival test. Results The groups were similar in terms of age, gender, left ventricular function, and number of previous sternotomies. In cases of isolated AVR, su-AVR had significantly lower cross clamp times than cAVR (71 vs. 86 min, p = 0.03). Postoperatively, 4 cAVR patients required pacemaker compared to zero patients in the su-AVR group. There were no significant differences between the two groups in terms of postoperative complications, intrahospital stay (median 9 days, IQR 7–20), or in-hospital mortality (1 su-AVR; 2 cAVR). The long-term survival rate was similar between the su-AVR (90%) and cAVR (92%) groups (log rank p = 0.8). The transvalvular gradients at follow-up were not affected by the type of valve used, regardless of the valve size (coef 2.68, 95%CI -3.14–8.50, p = 0.36). Conclusion The study suggests that su-AVR is a feasible and safe alternative to cAVR in high-risk patients undergoing redo surgery. The use of su-AVR offers comparable outcomes to cAVR, with reduced cross clamp times and a lower incidence of postoperative pacemaker requirement in isolated AVR cases. The results of this study contribute to the growing body of evidence supporting the use of su-AVR in high-risk patients, highlighting its feasibility and safety in redo surgeries. |
| first_indexed | 2024-03-08T16:24:31Z |
| format | Article |
| id | doaj.art-a583b2b7833a42dabf2f8f1bbef7d6f1 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-08T16:24:31Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-a583b2b7833a42dabf2f8f1bbef7d6f12024-01-07T12:10:04ZengBMCBMC Cardiovascular Disorders1471-22612024-01-0124111210.1186/s12872-023-03652-7Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomesIan Cummings0M Yousuf Salmasi1Halil Ibrahim Bulut2Alicja Zientara3Mahmoud AlShiekh4George Asimakopoulos5Department of Cardiac Surgery, St Thomas HospitalDepartment of Surgery, Imperial College London, QEQM BuildingDepartment of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation TrustDepartment of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation TrustDepartment of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation TrustDepartment of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation TrustAbstract Objective This retrospective study aimed to compare the outcomes of sutureless aortic valve replacement (su-AVR) and conventional bioprosthetic sutured AVR (cAVR) in high-risk patients undergoing redo surgery. Methods A total of 79 patients who underwent redo AVR between 2014 and 2021 were included in the study. Of these, 27 patients underwent su-AVR and 52 underwent cAVR. Patient characteristics and clinical outcomes were analysed using multivariate regression and Kaplan Meier survival test. Results The groups were similar in terms of age, gender, left ventricular function, and number of previous sternotomies. In cases of isolated AVR, su-AVR had significantly lower cross clamp times than cAVR (71 vs. 86 min, p = 0.03). Postoperatively, 4 cAVR patients required pacemaker compared to zero patients in the su-AVR group. There were no significant differences between the two groups in terms of postoperative complications, intrahospital stay (median 9 days, IQR 7–20), or in-hospital mortality (1 su-AVR; 2 cAVR). The long-term survival rate was similar between the su-AVR (90%) and cAVR (92%) groups (log rank p = 0.8). The transvalvular gradients at follow-up were not affected by the type of valve used, regardless of the valve size (coef 2.68, 95%CI -3.14–8.50, p = 0.36). Conclusion The study suggests that su-AVR is a feasible and safe alternative to cAVR in high-risk patients undergoing redo surgery. The use of su-AVR offers comparable outcomes to cAVR, with reduced cross clamp times and a lower incidence of postoperative pacemaker requirement in isolated AVR cases. The results of this study contribute to the growing body of evidence supporting the use of su-AVR in high-risk patients, highlighting its feasibility and safety in redo surgeries.https://doi.org/10.1186/s12872-023-03652-7PercevalSuturelessAortic valve replacementRedo cardiac surgery |
| spellingShingle | Ian Cummings M Yousuf Salmasi Halil Ibrahim Bulut Alicja Zientara Mahmoud AlShiekh George Asimakopoulos Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes BMC Cardiovascular Disorders Perceval Sutureless Aortic valve replacement Redo cardiac surgery |
| title | Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes |
| title_full | Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes |
| title_fullStr | Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes |
| title_full_unstemmed | Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes |
| title_short | Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes |
| title_sort | sutureless biological aortic valve replacement su avr in redo operations a retrospective real world experience report of clinical and echocardiographic outcomes |
| topic | Perceval Sutureless Aortic valve replacement Redo cardiac surgery |
| url | https://doi.org/10.1186/s12872-023-03652-7 |
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