title: Immediate outcome after sutureless versus transcatheter aortic valve replacement.
abstract: The aim of this study was to compare the immediate outcome of patients undergoing transcatheter (TAVI) versus surgical aortic valve replacement with the sutureless Perceval bioprosthesis (SU-AVR). This is a retrospective multicenter analysis of 773 patients who underwent either TAVI (394 patients, mean age, 80.8 ± 5.5 years, mean EuroSCORE II 5.6 ± 4.9 %) or SU-AVR (379 patients, 77.4 ± 5.4 years, mean EuroSCORE II 4.0 ± 3.9 %) with or without concomitant myocardial revascularization. Data on SU-AVRs were provided by six European institutions (Belgium, Finland, Germany, Italy and Sweden) and data on TAVIs were provided by a single institution (Catania, Italy). In-hospital mortality was 2.6 % after SU-AVR and 5.3 % after TAVI (p = 0.057). TAVI was associated with a significantly high rate of mild (44.0 vs. 2.1 %) and moderate-severe paravalvular regurgitation (14.1 vs. 0.3 %, p < 0.0001) as well as the need for permanent pacemaker implantation (17.3 vs. 9.8 %, p = 0.003) compared with SU-AVR. The analysis of patients within the 25th and 75th percentiles interval of EuroSCORE II, i.e., 2.1-5.8 %, confirmed the findings of the overall series. One-to-one propensity score-matched analysis resulted in 144 pairs with similar baseline characteristics and operative risk. Among these matched pairs, in-hospital mortality (6.9 vs. 1.4 %, p = 0.035) was significantly higher after TAVI. SU-AVR with the Perceval prosthesis in intermediate-risk patients is associated with excellent immediate survival and is a valid alternative to TAVI in these patients.
authors.affiliation: Department of Surgery, Oulu University Hospital, PL 21, 90029, OYS, Oulu, Finland. faustobiancari@yahoo.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.affiliation: Department of Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Wanda
authors.initials: W
authors.lastname: Deste
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Gulino
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Immè
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Di Simone
authors.affiliation: Cardiology Unit, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Denise
authors.initials: D
authors.lastname: Todaro
authors.affiliation: Department of Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pollari
authors.affiliation: Department of Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein
authors.affiliation: Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kasama
authors.affiliation: Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Meuris
authors.affiliation: Division of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Dalén
authors.affiliation: Division of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Sartipy
authors.affiliation: Division of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.affiliation: Department of Surgery, Oulu University Hospital, PL 21, 90029, OYS, Oulu, Finland.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Lahtinen
authors.affiliation: Department of Surgery, Oulu University Hospital, PL 21, 90029, OYS, Oulu, Finland.
authors.forename: Jouni
authors.initials: J
authors.lastname: Heikkinen
authors.affiliation: Department of Surgery, Oulu University Hospital, PL 21, 90029, OYS, Oulu, Finland.
authors.forename: Tatu
authors.initials: T
authors.lastname: Juvonen
authors.affiliation: Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatti
authors.affiliation: Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
authors.forename: Aniello
authors.initials: A
authors.lastname: Pappalardo
authors.affiliation: Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Mignosa
authors.affiliation: Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy.
authors.forename: Antonino S
authors.initials: AS
authors.lastname: Rubino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016009:Chi-Square Distribution; D005060:Europe; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D057216:Propensity Score; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D000071062:Sutureless Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: AVR; Aortic valve replacement; Perceval; Sutureless; TAVI; Transcatheter