• Heart and vessels · Mar 2016

    Multicenter Study Comparative Study

    Immediate outcome after sutureless versus transcatheter aortic valve replacement.

    • Fausto Biancari, Marco Barbanti, Giuseppe Santarpino, Wanda Deste, Corrado Tamburino, Simona Gulino, Sebastiano Immè, Emanuela Di Simone, Denise Todaro, Francesco Pollari, Theodor Fischlein, Keiichiro Kasama, Bart Meuris, Magnus Dalén, Ulrik Sartipy, Peter Svenarud, Jarmo Lahtinen, Jouni Heikkinen, Tatu Juvonen, Giuseppe Gatti, Aniello Pappalardo, Carmelo Mignosa, and Antonino S Rubino.
    • Department of Surgery, Oulu University Hospital, PL 21, 90029, OYS, Oulu, Finland. faustobiancari@yahoo.it.
    • Heart Vessels. 2016 Mar 1; 31 (3): 427-33.

    AbstractThe 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.

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