Sutureless aortic valve replacement with Perceval bioprosthesis showed lower incidence of new-onset myocardial infarction and favorable mid-term overall survival compared to TAVI.
Meta-Analysis
Does sutureless aortic valve replacement using the Perceval bioprosthesis improve outcomes compared to transcatheter aortic valve implantation in patients with aortic valve pathologies in the gray zone?
SUAVR with the Perceval bioprosthesis may offer a lower incidence of certain complications and favorable mid-term survival compared to TAVI for gray-zone aortic valve patients, despite higher risks of AF and bleeding.
Background: The management of patients with aortic valve pathologies can sometimes fall into a “gray zone”, where the optimal treatment approach is not straightforward. The comparative benefits of sutureless aortic valve replacement (SUAVR) using the Perceval bioprosthesis versus transcatheter aortic valve implantation (TAVI) for the “gray zone” of aortic valve replacement procedures remain a topic of debate. To further explore this issue, we conducted a study with pairwise, single-arm, and Kaplan–Meier-based meta-analyses to compare the outcomes of SUAVR with the Perceval bioprosthesis versus TAVI, as well as to evaluate the efficacy, safety, and durability of SUAVR with the Perceval bioprosthesis over mid-term and long-term follow-up periods. Methods: The PubMed, PubMed Central, OVID Medline, Cochrane Library, Embase, and Web of Science databases were systematically searched. All study types were included, except study protocols and animal studies, without time restrictions. The final search was carried out in May 2024. Results: No statistically significant differences were observed in permanent pacemaker implantation (PPI) rates between the two groups. SUAVR showed a lower incidence of new-onset myocardial infarction but was associated with higher rates of new-onset atrial fibrillation and major bleeding. TAVI had higher rates of left bundle branch block and major vascular complications. Conclusions: Our findings show that SUAVR has a lower incidence of complications and a favorable mid-term overall survival compared to TAVI. SUAVR has more advantages compared to TAVI and can be considered a valuable and promising option for the “grey zone” of aortic valve pathologies.
Ali‐Hasan‐Al‐Saegh et al. (Mon,) conducted a meta-analysis in Aortic valve pathologies. Sutureless aortic valve replacement (SUAVR) with Perceval bioprosthesis vs. Transcatheter aortic valve implantation (TAVI) was evaluated on Permanent pacemaker implantation (PPI) rates and clinical complications. Sutureless aortic valve replacement with Perceval bioprosthesis showed lower incidence of new-onset myocardial infarction and favorable mid-term overall survival compared to TAVI.