Sutureless aortic valve replacement safe

Sutureless aortic valve replacement (SU-AVR) is a relatively safe procedure, with low rates of short-term mortality and complications, reports a recent meta-analysis.

After searching through six electronic databases and applying the selection criteria, the researchers eventually identified 24 studies eligible for quantitative and qualitative analysis. The pooled sample included 5,073 patients undergoing SU-AVR assessed primarily for safety outcomes, such as death risk and thromboembolic events, among others.

Twenty-three studies yielded a cumulative 30-day mortality rate of 2.5 percent, while seven studies had a 1-year rate of 2.7 percent. Over the same respective time intervals, the pooled incidence rates of thromboembolic events were 2.8 percent and 1.6 percent. Subgroup analysis showed that valve type may be an important modifier, with the Perceval S and Intuity devices having significantly differing rates.

Paravalvular leakage requiring surgical intervention had an incidence rate of 0.5 percent at 30 days, according to a cumulative analysis of 18 studies. At the 1 year mark, the corresponding value was 0.3 percent. Severe patient prosthesis mismatch was likewise rare, occurring at rates of 0.7 percent and 6.4 percent, at the respective time points.

Conductive disorders requiring permanent pacemaker placement was reported in 7 percent at 30 days and 1.4 percent at 1 year.

“More studies and registry data with longer follow-up periods, larger sample sizes, and more randomization and blinding are needed to evaluate the long-term safety and effectiveness of SU aortic valves,” researchers said.