Sutureless Versus Rapid Deployment Aortic Valve Replacement: Results From a Multicenter Registry

BACKGROUND This study compared clinical and hemodynamic in-hospital outcomes of patients undergoing suture -less vs rapid deployment aortic valve replacement (SURD-AVR) in the large population of the Sutureless and Rapid Deployment International Registry (SURD-IR). METHODS We examined 4695 patients who underwent isolated or combined SURD-AVR. The sutureless Perceval valve (LivaNova PLC, London, United Kingdom) was used in 3133 patients and the rapid deployment Intuity (Edwards Life -sciences, Irvine, CA) in 1562. Potential confounding factors were addressed by the use of propensity score matching. After matching, 2 well-balanced cohorts of 823 pairs (isolated SURD-AVR) and 467 pairs (combined SURD-AVR) were created. RESULTS Patients who received Perceval and Intuity valves showed similar in-hospital mortality and rate of major post-operative complications. Perceval was associated shorter cross-clamp and cardiopulmonary bypass times. In the isolated SURD-AVR group, patients receiving Perceval were more likely to undergo anterior right thoracotomy incision. Postoperative transvalvular gradients were significantly lower for the Intuity valve compared with those of the Perceval valve, either in isolated and combined SURD-AVR. The Intuity valve was associated with a lower rate of postoperative mild aortic regurgitation. CONCLUSIONS Our results confirm the safety and efficacy of SURD-AVR regardless of the valve type. The Perceval valve was associated with reduced operative times and increased anterior right thoracotomy incision. The Intuity valve showed superior hemodynamic outcomes and a lower incidence of postoperative mild aortic regurgitation. (Ann Thorac Surg 2022;114:758-66) (c) 2022 by The Society of Thoracic Surgeons

Automated summary

This study compared the clinical and hemodynamic outcomes of sutureless and rapid deployment aortic valve replacement (SURD-AVR). The results showed that both procedures had similar in-hospital mortality and rate of major post-operative complications. The sutureless Perceval valve was associated with shorter operative times and increased anterior right thoracotomy incision, while the rapid deployment Intuity valve showed superior hemodynamic outcomes and a lower incidence of postoperative mild aortic regurgitation.