Key result
SuAVR earns ~73% preference among Canadian surgeons for hostile roots, despite cost barriers.
Why the study?
Sutureless aortic valve replacement is gaining popularity for treating aortic stenosis, but Canadian cardiac surgeons' practice patterns and perceptions regarding it had not been described.
Cross-Sectional (n=66)
Yes
Canadian cardiac surgeons primarily select sutureless aortic valve replacement for patients with high surgical risk and anatomical challenges, though cost remains a primary barrier to its use.
Survey preferences favor SuAVR in hostile roots or small annuli despite cost barriers; leaves open real-world adoption and outcome impacts.
BACKGROUND: Sutureless aortic valve replacement (SuAVR) is gaining popularity for the treatment of aortic stenosis. We aimed to describe Canadian cardiac surgeons' practice patterns and perceptions regarding SuAVR. METHODS: Content experts (clinicians and methodologists) developed the survey. Domains in the questionnaire include: respondent characteristics, factors influencing the decision to implant a SuAVR, barriers to SuAVR use, and interest in participating in a trial. RESULTS: A total of 66 cardiac surgeons (median duration of practice: 15 years; range 8-20 years) from 18 hospitals across Canada responded to the survey for a response rate of 84%. Surgeons reported that the following patient characteristics increased the likelihood they would choose SuAVR: hostile root (73%), small annular size (55%), high Society of Thoracic Surgery risk score (42%), older age (40%), to support minimally invasive surgery (25%) and redo-operation (23%). The following patient characteristics made surgeons less likely to pursue SuAVR: young age (73%), low STS score (40%), and large annular size (30%). Reported barriers to SuAVR use included: cost (33%), permanent pacemaker risk (27%) and uncertain durability (12%). Of respondents, 73% were interested in participating in a randomized controlled trial comparing SuAVR with transcatheter aortic valve replacement. CONCLUSIONS: The primary reasons for surgeons selecting SuAVR were high surgical risk and anatomical challenges. Cost is a primary factor limiting SuAVR use.
No takes yet. Share an insight, caveat, or question.
Makhdoum et al. (2022) conducted a cross-sectional in Aortic stenosis (n=66). Sutureless aortic valve replacement (SuAVR) was evaluated on Practice patterns and perceptions regarding SuAVR. Sutureless aortic valve replacement was favored by Canadian cardiac surgeons for patients with a hostile root (73%) or small annulus (55%), while cost (33%) was a primary barrier to its use.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: