Key result
Minimally invasive aortic valve replacement with a sutureless bioprosthesis significantly reduced aortic cross-clamp time (27.1 vs 53.9 min, p<0.01) compared to conventional stented valves, but increased the need for pacemaker implantation (8.3% vs 1.9%, p=0.05).
Why the study?
Minimally invasive approaches for AVR are clinically beneficial but technically demanding, prompting evaluation of initial outcomes in patients aged >75 years after establishing a sutureless minimally invasive program.
Does a sutureless bioprosthesis via a minimally invasive approach improve surgical times and clinical outcomes compared to a conventional stented valve via full sternotomy in patients over 75 years old requiring isolated AVR?
Population
95 propensity score-matched pairs aged >75 years undergoing isolated elective AVR
Comparison
Minimally invasive sutureless bioprosthesis vs full median sternotomy stented valve
Design
Propensity score-matched comparative study
Authors
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Initial sutureless AVR experience in elderly patients supports feasibility; hypothesis-generating and requires randomized confirmation before practice change.
Observational (n=190)
No
Does a sutureless bioprosthesis via a minimally invasive approach improve surgical times and clinical outcomes compared to a conventional stented valve via full sternotomy in patients over 75 years old requiring isolated AVR?
Absolute Event Rate: 27.1% vs 53.9%
p-value: p=<0.01
Sutureless minimally invasive aortic valve replacement is safe and significantly reduces surgical times, blood transfusions, and hospital stay compared to conventional sternotomy, though it carries a higher risk of pacemaker implantation.
Francisco Estévez (2025) conducted an observational in Isolated elective aortic valve replacement (n=190). Minimally invasive sutureless aortic valve replacement vs. Conventional stented aortic valve replacement via full median sternotomy was evaluated on Aortic cross-clamp time (minutes) (p=<0.01). Minimally invasive aortic valve replacement with a sutureless bioprosthesis significantly reduced aortic cross-clamp time (27.1 vs 53.9 min, p<0.01) compared to conventional stented valves, but increased the need for pacemaker implantation (8.3% vs 1.9%, p=0.05).
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