Safety and Haemodynamic Outcomes of Currently Available Suture-less Aortic Valves in Patients With Aortic Stenosis: A Meta-Analysis.


Journal

Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 17 09 2019
revised: 23 01 2020
accepted: 15 02 2020
pubmed: 2 5 2020
medline: 14 4 2021
entrez: 2 5 2020
Statut: ppublish

Résumé

Suture-less aortic valves aim to achieve better outcomes and to aid and facilitate the minimally invasive aortic valve replacement procedure by tackling the issue of cross-clamp time, which is an independent predictor of postoperative outcomes, especially in patients with serious comorbidities. By reducing the number of sutures, the time for suture placement is reduced. Our meta-analysis tried to assess the safety and haemodynamic performance of the suture-less aortic valve prostheses to ascertain their benefits as a viable alternative to current established measures. From their inceptions to February 2017, six electronic databases were searched. Relevant studies using commercially accessible suture-free valves to replace the aortic valve have been recognised. Based on the predefined endpoints, data were collected and analysed. For incorporation in qualitative and quantitative analyses, 24 studies were recognised, with a total number of 5,073 patients undergoing suture-less aortic valve replacement. Mortality incidence at the 30-day and 12-month follow-ups were 2.5% and 2.7%, respectively, while the incidences of thromboembolic events (1.6%) and paravalvular leak (0.5%) were acceptable. Current available evidence indicates that sutureless aortic valve replacement is a safe operation showing low mortality and complication rates, with satisfactory haemodynamic performance.

Sections du résumé

BACKGROUND BACKGROUND
Suture-less aortic valves aim to achieve better outcomes and to aid and facilitate the minimally invasive aortic valve replacement procedure by tackling the issue of cross-clamp time, which is an independent predictor of postoperative outcomes, especially in patients with serious comorbidities. By reducing the number of sutures, the time for suture placement is reduced. Our meta-analysis tried to assess the safety and haemodynamic performance of the suture-less aortic valve prostheses to ascertain their benefits as a viable alternative to current established measures.
METHOD METHODS
From their inceptions to February 2017, six electronic databases were searched. Relevant studies using commercially accessible suture-free valves to replace the aortic valve have been recognised. Based on the predefined endpoints, data were collected and analysed.
RESULTS RESULTS
For incorporation in qualitative and quantitative analyses, 24 studies were recognised, with a total number of 5,073 patients undergoing suture-less aortic valve replacement. Mortality incidence at the 30-day and 12-month follow-ups were 2.5% and 2.7%, respectively, while the incidences of thromboembolic events (1.6%) and paravalvular leak (0.5%) were acceptable.
CONCLUSIONS CONCLUSIONS
Current available evidence indicates that sutureless aortic valve replacement is a safe operation showing low mortality and complication rates, with satisfactory haemodynamic performance.

Identifiants

pubmed: 32354587
pii: S1443-9506(20)30069-X
doi: 10.1016/j.hlc.2020.02.006
pii:
doi:

Types de publication

Journal Article Meta-Analysis Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1301-1309

Informations de copyright

Copyright © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Auteurs

Mohamed Amer (M)

Mahala Cardiac Center, El Gharbeya, Egypt.

Mohammed Abd Al Jawad (MA)

Department of Cardio-Thoracic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: mohammed_abdaljawad@med.asu.edu.eg.

Ahmed Omar (A)

Department of Cardio-Thoracic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Hany Metwaly (H)

Department of Cardio-Thoracic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

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Classifications MeSH