Conventional surgery, sutureless valves, and transapical aortic valve replacement: What is the best option for patients with aortic valve stenosis? A multicenter, propensity-matched analysis

Augusto D'Onofrio, Giulio Rizzoli, Antonio Messina, Ottavio Alfieri, Roberto Lorusso, Stefano Salizzoni, Mattia Glauber, Roberto Di Bartolomeo, Laura Besola, Mauro Rinaldi, Giovanni Troise, Gino Gerosa

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Although surgical aortic valve replacement (SAVR) is the treatment of choice for patients with aortic valve stenosis, transcatheter aortic valve replacement (TAVR) and sutureless aortic valve replacement (SU-AVR) have shown good results. The aim of our multicenter, propensity-matched study was to compare the clinical and hemodynamic outcomes of surgical SAVR, transapical TAVR (TA-TAVR), and SU-AVR. Methods We analyzed data from 566 TA-TAVR, 349 SAVR, and 38 SU-AVR patients treated from January 2009 to March 2012. We used a propensity-matching strategy to compare on-pump (SAVR, SU-AVR) and off-pump (TA-TAVR) surgical techniques. The outcomes were analyzed using multivariate weighted logistic regression or multinomial logistic analysis. Results In the matched cohorts, the 30-day overall mortality was significantly lower after SAVR than TA-TAVR (7% vs 1.8%, P =.026), with no differences in mortality between SU-AVR and TA-TAVR. Multivariate analysis showed SU-AVR to have a protective effect, although not statistically significant, against aortic regurgitation, pacemaker implantation, and renal replacement therapy compared with TA-TAVR. Compared with TA-TAVR, SAVR demonstrated significant protection against aortic regurgitation (odds ratio, 0.04; P

Original languageEnglish
Pages (from-to)1065-1071
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume146
Issue number5
DOIs
Publication statusPublished - Nov 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Fingerprint Dive into the research topics of 'Conventional surgery, sutureless valves, and transapical aortic valve replacement: What is the best option for patients with aortic valve stenosis? A multicenter, propensity-matched analysis'. Together they form a unique fingerprint.

Cite this