Comparison of Postoperative Outcomes of Sutureless versus Stented Bioprosthetic Aortic Valve Replacement

Abstract Objective: Sutureless aortic valve replacement (Su-AVR) offers an alternative to supra-annular stented biological aortic prostheses. This single-center study aimed to compare early outcomes after aortic valve replacement with sutureless and conventional stented bioprostheses. Methods: In this retrospective study, we analyzed 52 patients who underwent aortic valve replacement with sutureless and stented bioprostheses between January 2013 and October 2017. Sorin Perceval S sutureless valves were implanted in group 1 and Sorin Mitroflow stented bioprosthetic valves were used in group 2. Postoperative outcomes, including demographics, cardiopulmonary bypass (CPB) times, cross-clamp times, morbidity and mortality, as well as echocardiography in the first month, were compared. Results: Mortality occurred in 1 (3.6%) patient in group 1, and in 2 (8.3%) patients in group 2 (P=0.186). Group 1 had significantly shorter CPB (61.6±26.1 min vs. 106.3±32.7 min, P=0.001) and cross-clamp (30.9±13.6 min vs. 73.3±17.3 min, P=0.001) times. The length of stay in the intensive care unit (1.9±1.3 days vs. 2.4±4.9 days, P=0.598) and hospital stay (7.6±2.7 days vs. 7.3±2.6 days, P=0.66) were similar. Postoperatively, there was no statistically significant difference between the two groups in echocardiography results, and morbidities. The mean aortic valve gradient was 13.5±5.8 mmHg in group 1 and 14.5±8.0 mmHg in group 2 (P=0.634). Paravalvular regurgitation was diagnosed in 3 (10.7%) patients in group 1 and in 1 (4.2%) patient in group 2 (P=0.220). Conclusions: Su-AVR resulted in shorter cross-clamp and CPB times. However, early mortality, postoperative morbidity, and echocardiography results were similar between groups.## 研究目的 无缝合主动脉瓣置换术（Sutureless Aortic Valve Replacement, Su-AVR）可作为瓣上型带支架生物主动脉瓣膜假体的替代治疗方案。本单中心回顾性研究旨在对比无缝合式与传统带支架生物瓣膜行主动脉瓣置换术后的早期临床结局。 ## 研究方法 本回顾性研究纳入并分析2013年1月至2017年10月期间接受无缝合式或传统带支架生物瓣膜主动脉瓣置换术的52例患者。其中第1组植入索林Perceval S无缝合瓣膜，第2组使用索林Mitroflow带支架生物瓣膜。对比两组患者的人口统计学特征、体外循环（cardiopulmonary bypass, CPB）时长、主动脉阻断时长、并发症发生率、死亡率以及术后1个月的超声心动图检查结果等术后结局指标。 ## 研究结果 第1组1例（3.6%）患者死亡，第2组2例（8.3%）患者死亡，组间差异无统计学意义（P=0.186）。第1组的体外循环时长（61.6±26.1 min vs 106.3±32.7 min，P=0.001）与主动脉阻断时长（30.9±13.6 min vs 73.3±17.3 min，P=0.001）均显著短于第2组。两组的重症监护病房（intensive care unit, ICU）停留时长（1.9±1.3 d vs 2.4±4.9 d，P=0.598）与住院时长（7.6±2.7 d vs 7.3±2.6 d，P=0.66）无显著差异。术后超声心动图结果与并发症发生率组间均无统计学差异：第1组平均主动脉瓣跨瓣压差为13.5±5.8 mmHg，第2组为14.5±8.0 mmHg（P=0.634）；第1组3例（10.7%）患者诊断为瓣周反流，第2组1例（4.2%）患者出现该情况（P=0.220）。 ## 研究结论 无缝合主动脉瓣置换术可缩短主动脉阻断与体外循环时长，但两组的早期死亡率、术后并发症发生率及术后超声心动图结果均无显著差异。