title: A Meta-Analysis Examining Differences in Short-Term Outcomes Between Sutureless and Conventional Aortic Valve Prostheses.
abstract: OBJECTIVE
  Sutureless aortic valve prostheses are anchored by radial force in a mechanism similar to that of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is associated with an increased permanent pacemaker (PPM) requirement in a significant proportion of patients. We undertook a meta-analysis to examine the incidence of PPM insertion associated with sutureless compared with conventional surgical aortic valve replacement.
  
  
  METHODS
  A systematic review was conducted in accordance with the Prisma guidelines. All searches were performed on August 10, 2014. Studies between 2007 and 2014 were included in the search.
  
  
  RESULTS
  A total of 832 patients were included in the sutureless group and 3,740 in the conventional group. Aortic cross-clamp (39.8 vs 62.4 minutes; P < 0.001) and cardiopulmonary bypass (64.9 vs 86.7 minutes; P = 0.002) times were shorter in the sutureless group. Permanent pacemaker implantation rate was higher in the sutureless cohort (9.1% vs 2.4%; P = 0.025).
  
  
  CONCLUSIONS
  Sutureless aortic valve prostheses are associated with significantly shorter cardiopulmonary bypass and aortic cross-clamp times and a higher incidence of PPM insertion than conventional. Further investigation of the prognostic significance is required.
authors.affiliation: From the *The Heart Team, Mater Private Hospital, Dublin, Ireland; and †CSTAR Centre for Statistical Training and Research, University College, Dublin, Ireland.
authors.forename: Eoghan T
authors.initials: ET
authors.lastname: Hurley
authors.forename: Katie E
authors.initials: KE
authors.lastname: O'Sullivan
authors.forename: Ricardo
authors.initials: R
authors.lastname: Segurado
authors.forename: John P
authors.initials: JP
authors.lastname: Hurley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000706:statistics & numerical data; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data; D011474:Prosthesis Design; D018570:Risk Assessment; D013536:Suture Techniques; D016896:Treatment Outcome