Zubarevich, Alina, Szczechowicz, Marcin, Amanov, Lukman, Arjomandi Rad, Arian ORCID: 0000-0002-4931-4049, Osswald, Anja, Torabi, Saeed, Ruhparwar, Arjang and Weymann, Alexander (2022). Non-Inferiority of Sutureless Aortic Valve Replacement in the TAVR Era: David versus Goliath. Life-Basel, 12 (7). BASEL: MDPI. ISSN 2075-1729

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Abstract

Background: The rapid development of transcatheter treatment methods has made transcatheter aortic valve replacement (TAVR) a feasible alternative to conventional surgical aortic valve replacement (SAVR). Recently, indications for TAVR have been expanded to intermediate- and low-risk patients, although there still remains a portion of ineligible patients. We sought to evaluate and compare our experience with sutureless SAVR and transapical TAVR in the grey-area of patients unsuitable for transfemoral access. Methods: Between April 2018 and June 2021, 248 consecutive patients underwent a sutureless SAVR (SU-SAVR) or TA-TAVR at our institution. We performed a pair-matched analysis and identified 56 patient pairs based on the EuroSCORE II. All transcatheter procedures were performed using SAPIEN XT/3 (TM) prostheses, while all surgical procedures deployed the Perceval (LivaNova) aortic valve. Results: All patients presented with multiple comorbidities as reflected by the median EuroSCORE-II of 3.1% (IQR 1.9-5.3). Thirty-four patients from the surgical group (60.7%) underwent a concomitant myocardial revascularization. There was no significant difference in major adverse events, pacemaker implantation or postoperative mortality during follow-up. Both interventions demonstrated technical success with similar mean postoperative pressure gradients at follow-up and no cases of paravalvular leakage. Conclusions: Sutureless aortic valve replacement constitutes a feasible treatment alternative for patients with aortic valve disease who are ineligible for transfemoral access route and/or require concomitant coronary revascularization. With its excellent hemodynamic performance, similar survival compared to TA-TAVR, and high cost-efficiency without compromising the postoperative outcomes and in-hospital length of stay SU-AVR might be considered for patients in the grey-area between TAVR and SAVR.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Zubarevich, AlinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Szczechowicz, MarcinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amanov, LukmanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arjomandi Rad, ArianUNSPECIFIEDorcid.org/0000-0002-4931-4049UNSPECIFIED
Osswald, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Torabi, SaeedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruhparwar, ArjangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weymann, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-674152
DOI: 10.3390/life12070979
Journal or Publication Title: Life-Basel
Volume: 12
Number: 7
Date: 2022
Publisher: MDPI
Place of Publication: BASEL
ISSN: 2075-1729
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CONVENTIONAL SURGERY; TRANSCATHETER; IMPLANTATION; METAANALYSIS; ZONEMultiple languages
Biology; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/67415

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