Early- and mid-term results of sutureless aortic valve replacement in high-risk patients: our single-center experience

Background: In this study, we present early-and mid-term results of sutureless bioprosthetic aortic valve replacement in high-risk patients with severe calcific aortic stenosis. Methods: Between July 2014 and July 2015, 27 patients (9 males, 18 females; mean age 72.96 +/- 6.15 years; range 62 to 85 years) who underwent sutureless bioprosthetic aortic valve replacement using one of three types (3F Enable, Perceval S, and Edwards) were included in the study. Demographic data of the patients and echocardiographic findings at discharge, three and six months were compared. Results: Eleven patients underwent aortic valve replacement in conjunction with coronary artery bypass grafting. The mean total perfusion time and aortic cross-clamp time were 84.2 +/- 33.8 min and 45.2 +/- 19.2 min, respectively. Good hemodynamic performance and low aortic gradient were detected on follow-up echocardiographies of the patients. The septal thickness was lower at three months and thereafter on echocardiography, than the discharge echocardiography (p=0.008). Two patients were reoperated due to prosthetic valve migration and advanced paravalvular leak. Two patients died due to non-cardiac causes in the 37th and 81st postoperative days. Conclusion: Although complications related to valve such as migration and paravalvular insufficiency may be seen in the early period after the procedure, sutureless aortic valve replacement the main advantages include shortened total perfusion time and aortic cross-clamp time.