World Journal of Cardiology最新文献

{"title":"Low-pressure tamponade due to hemothorax after transcatheter edge-to-edge repair of the mitral valve.","authors":"Nicholas Seidler, Shyamal R Asher, Tzonghuei Chen, Paul Gordon, Neel Sodha, Andrew Maslow","doi":"10.4330/wjc.v17.i5.106567","DOIUrl":"10.4330/wjc.v17.i5.106567","url":null,"abstract":"<p><strong>Background: </strong>The use of percutaneous transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) has increased, including an increased application to older, frailer, and higher risk patients.</p><p><strong>Case summary: </strong>A 74 year-old woman with severe MR, a left ventricular ejection fraction of 45%, and a small circumferential pericardial effusion underwent TEER of the mitral valve. After the placement of two MitraClips, the MR was assessed as mild to moderate. Within 10-20 minutes after the completion of the case, the patient was dyspneic and hypotensive despite volume resuscitation. Point-of-care ultrasound (POCUS) showed no changes in cardiac contractility, valve function, or the pericardial space. The right heart chambers appeared small with right atrial (RA) diastolic collapse. There was no evidence of venous congestion. Further exam showed a large right pleural fluid collection. Given the clinical scenario of dyspnea, hypotension, and diastolic RA collapse, low-pressure tamponade was suspected. A thoracentesis expelled 1200 mL of blood with immediate hemodynamic improvement. The patient made an uneventful recovery.</p><p><strong>Conclusion: </strong>The application of POCUS is crucial for detecting, diagnosing, and properly managing cardiac dysfunction and procedural complications associated with TEER. While tamponade is classically associated with a pericardial effusion and vena caval plethora, their absence does not dismiss the suspicion or diagnosis of tamponade. This case highlights the value of POCUS in assessing low-pressure tamponade caused by a large, pressurized pleural effusion. Clinical suspicion, supported by POCUS findings, was confirmed by a thoracentesis that resulted in immediate hemodynamic improvement.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"106567"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National adult mortality trends due to chronic kidney disease-related atrial fibrillation in the United States from year 2011-2020.","authors":"Muhammad Abdullah Naveed, Faizan Ahmed, Ahila Ali, Sherif Eltawansy, Zaima Afzaal, Bazil Azeem, Muhammad Kashan, Omar Kamel, Hritvik Jain, Mushood Ahmed, Kainat Aman, Hira Zahid, Rabia Iqbal, Aman Ullah, Muhammad Naveed Zafar, Pawel Lajczak, Ogechukwu Obi, Raheel Ahmed","doi":"10.4330/wjc.v17.i5.105919","DOIUrl":"10.4330/wjc.v17.i5.105919","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) associated with chronic kidney disease (CKD) is a prevalent condition in the United States, significantly impacting global morbidity and mortality. Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.</p><p><strong>Aim: </strong>To investigate AF-CKD comorbidity and mortality on the national level.</p><p><strong>Methods: </strong>Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years. Age-adjusted mortality rates (AAMRs) per 100000 persons and annual percent change (APC) were calculated, stratified by year, sex, race/ethnicity, and geographic region.</p><p><strong>Results: </strong>A total of 110733 deaths occurred among adults (aged 35-85 or more years) related to AF associated with CKD in the United States. Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014 (APC: -14.89; 95% confidence interval (CI): -30.44 to -4.06), followed by an increase to 10.3 in 2020 (APC: 9.91; 95%CI: 6.1-19.62). Men had higher AAMRs than women (men: 7.6, 95%CI: 7.6-7.7). Non-Hispanic White adults had the highest AAMR (7.8), followed by non-Hispanic Black (5). States in the top 90^th percentile had approximately four times higher AAMRs than those in the lower 10^th percentile. AAMR also varied by region (Midwest: 7.6, West: 6.7, Northeast: 6.3, South: 5.6), with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.</p><p><strong>Conclusion: </strong>Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period, with notable disparities across demographic and geographic factors. Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"105919"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in risk stratification and treatment of acute pulmonary embolism.","authors":"George Latsios, Emmanouil Mantzouranis, Ioannis Kachrimanidis, Panagiotis Theofilis, Sotirios Dardas, Evaggelia Stroumpouli, Constantina Aggeli, Costas Tsioufis","doi":"10.4330/wjc.v17.i5.104983","DOIUrl":"10.4330/wjc.v17.i5.104983","url":null,"abstract":"<p><p>Pulmonary embolism (PE) represents the third leading cause of cardiovascular death, despite the implementation of European Society of Cardiology guidelines, the establishment of PE response teams and advances in diagnosis and treatment modalities. Unfavorable prognosis may be attributed to the increasing incidence of the disease and pitfalls in risk stratification using the established risk stratification tools that fail to recognize patients with intermediate-high risk PE at normotensive shock in order to prevent further deterioration. In this light, research has been focused to identify novel risk stratification tools, based on the hemodynamic impact of PE on right ventricular function. Furthermore, a growing body of evidence has demonstrated that novel interventional treatments for PE, including catheter directed thrombolysis, mechanical thrombectomy and computer-assisted aspiration, are promising solutions in terms of efficacy and safety, when targeted at specific populations of the intermediate-high- and high-risk spectrum. Various therapeutic protocols have been suggested worldwide, regarding the indications and proper timing for interventional strategies. A ST-elevation myocardial infarction-like timing approach has been suggested in high-risk PE with contraindications for fibrinolysis, while optimal timing of the procedure in intermediate-high risk patients is still a matter of debate; however, early interventions, within 24-48 hours of presentation, are associated with more favorable outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"104983"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finerenone and semaglutide: Role in heart failure with reduced ejection fraction.","authors":"Muhammad Abdul Rehman Gulzar","doi":"10.4330/wjc.v17.i5.105822","DOIUrl":"10.4330/wjc.v17.i5.105822","url":null,"abstract":"<p><p>Obesity and type 2 diabetes mellitus commonly coexist with heart failure (HF) and may contribute to the pathogenesis of HF with preserved ejection fraction. With progression in management therapies for HF with preserved ejection fraction, the mechanism behind beneficial actions of finerenone and semaglutide remains enigmatic. For decades, the cardiorenal protective effects of aldosterone blockage in patients with chronic kidney disease have been of significant interest. But due to multiple side effects, these trials were likely to stop.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"105822"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial ischemia in nonobstructive coronary arteries: A review of diagnostic dilemmas, current perspectives, and emerging therapeutic innovations.","authors":"Hariharan Seshadri, Dhaiyanitha Gunasekaran, Abdulkader Mohammad, Srinivas Rachoori, Hamrish Kumar Rajakumar","doi":"10.4330/wjc.v17.i5.106541","DOIUrl":"10.4330/wjc.v17.i5.106541","url":null,"abstract":"<p><p>Myocardial infarction with nonobstructive coronary arteries is a unique presentation of acute coronary syndrome occurring in patients without significant coronary artery disease. Its pathophysiology involves atherosclerotic and nonatherosclerotic mechanisms such as plaque erosion, coronary microvascular dysfunction, vasospasm, spontaneous coronary artery dissection, autoimmune and inflammatory diseases, and myocardial oxygen supply-demand imbalance. A systematic approach to diagnosis is needed due to the diverse range of underlying causes. Cardiac troponins confirm the myocardial injury and coronary angiography rules out significant obstruction. Cardiac magnetic resonance imaging differentiates ischemic from nonischemic causes, and additional investigations, such as intravascular ultrasound, optical coherence tomography, and provocative testing, play a role in identifying the etiology to guide management strategies. Atherosclerotic cases require antiplatelet therapy and statins, vasospastic cases respond to calcium channel blockers, spontaneous coronary artery dissection is typically managed conservatively, and coronary microvascular dysfunction may require vasodilators. Lifestyle modifications and cardiac rehabilitation are essential for improving outcomes. The prognosis of patients experiencing recurrent events despite treatment is uncertain, but long-term outcomes depend on the etiology, highlighting the need for personalized management. Future research should focus on refining diagnostic protocols and identifying optimal therapeutic strategies. Randomized controlled trials are necessary to establish evidence-based treatments for different subtypes of myocardial infarction with nonobstructive coronary arteries.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"106541"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of transcatheter <i>vs</i> surgical aortic valve replacement: A systematic review and meta-analysis.","authors":"Iman Moradi, Muhammad Saqlain Mustafa, Jannat Sardar Sheikh, Behrooz Shojai Rahnama, Matthew Fredericks, Anil Kumar Yennam, Mustafa Arain, Utsow Saha, Andrew Richard Ma, Adithya Nagendran, Moosa Bin Omer, Muhammad Armaghan, Diana Carolina Cortés Jaimes, Nagavenkata Lova Surya Vamsi Avinash Bojanki, Muhammad Ashir Shafique","doi":"10.4330/wjc.v17.i4.104168","DOIUrl":"https://doi.org/10.4330/wjc.v17.i4.104168","url":null,"abstract":"<p><strong>Background: </strong>The management of severe symptomatic aortic stenosis has been revolutionized by transcatheter aortic valve replacement (TAVR), offering a minimally invasive alternative to surgical aortic valve replacement (SAVR). However, the comparative safety and efficacy of these interventions remain subjects of ongoing investigation.</p><p><strong>Aim: </strong>To compare the clinical outcomes and safety of TAVR <i>vs</i> SAVR in patients with severe symptomatic aortic stenosis.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines. Randomized controlled trials (RCTs) comparing TAVR and SAVR were identified from databases including PubMed, Scopus, and Web of Science up to May 31, 2024. Data were extracted on clinical outcomes, including mortality, procedural complications, and post-procedure adverse events. Risk ratios (RRs) with 95%CIs were calculated using a random-effects model.</p><p><strong>Results: </strong>A total of 10 RCTs were included. TAVR demonstrated a significantly lower risk of acute kidney injury (RR: 0.33; 95%CI: 0.25-0.44), major bleeding (RR: 0.37; 95%CI: 0.30-0.46), and new-onset atrial fibrillation (RR: 0.44; 95%CI: 0.34-0.57) compared to SAVR. However, TAVR was associated with higher risks of new permanent pacemaker implantation (RR: 3.49; 95%CI: 2.77-4.39), major vascular complications (RR: 2.47; 95%CI: 1.91-3.21), and paravalvular leaks (RR: 4.15; 95%CI: 3.14-5.48). Mortality at 30 days was comparable (RR: 0.95; 95%CI: 0.78-1.15), but long-term mortality was slightly higher with TAVR in some analyses (RR: 1.23; 95%CI: 1.01-1.49). Rates of stroke (RR: 0.97; 95%CI: 0.81-1.17) and myocardial infarction (RR: 0.91; 95%CI: 0.67-1.24) were similar between the groups.</p><p><strong>Conclusion: </strong>TAVR offers a less invasive option with significant benefits in reducing acute kidney injury, major bleeding, and new-onset atrial fibrillation, making it particularly advantageous for high-risk surgical candidates. However, higher risks of permanent pacemaker implantation, vascular complications, and paravalvular leaks highlight the need for individualized patient selection and shared decision-making to optimize outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 4","pages":"104168"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging risk factors for heart failure in younger populations: A growing public health concern.","authors":"Razieh Parizad, Akash Batta, Juniali Hatwal, Mohammadreza Taban-Sadeghi, Bishav Mohan","doi":"10.4330/wjc.v17.i4.104717","DOIUrl":"https://doi.org/10.4330/wjc.v17.i4.104717","url":null,"abstract":"<p><p>Heart failure (HF) is a growing public health concern, with an increasing incidence among younger populations. Traditionally, HF was considered a condition primarily affecting the elderly, but of late, emerging evidence hints at a rapidly rising HF incidence in youth in the past 2 decades. HF in youth has been linked to a complex interaction between emerging risk factors, such as metabolic syndrome, environmental exposures, genetic predispositions, and lifestyle behaviors. This review examines these evolving determinants, including substance abuse, autoimmune diseases, and the long-term cardiovascular effects of coronavirus disease 2019, which disproportionately affect younger individuals. Through a comprehensive analysis, the study highlights the importance of early detection, targeted prevention strategies, and multidisciplinary management approaches to address this alarming trend. Promoting awareness and integrating age-specific interventions could significantly reduce the burden of HF and improve long-term outcomes among younger populations.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 4","pages":"104717"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-output heart failure secondary to iatrogenic arteriovenous fistula: A case report.","authors":"Ting He, Xin He, Xu-Ming Yuan","doi":"10.4330/wjc.v17.i4.104748","DOIUrl":"https://doi.org/10.4330/wjc.v17.i4.104748","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous fistula is a rare cause of refractory heart failure, and corrective measures may lead to dramatic improvement; however, the long-term cardiac remodeling outcomes, particularly after delayed closure, remain unclear.</p><p><strong>Case summary: </strong>A 57-year-old man was admitted to the hospital with complaints of exertional dyspnea for more than 10 years. Physical examination revealed wet crackles in the lungs and a continuous machinery murmur in the left lower back and groin area. Asymmetric edema and varicose veins were observed in the lower limbs. Echocardiography revealed a dilated right ventricle with severe pulmonary hypertension. Computed tomography revealed a left common iliac arteriovenous fistula linked to prior lumbar disc surgery. Surgical repair resolved the symptoms, with echocardiography at 4 months showing a reduced right atrium (RA) and ventricular (RV) diameter and tricuspid regurgitation. However, during the 2-year follow-up, gradual RA and RV re-expansion (from 35 mm to 51 mm and from 26 mm to 46 mm, respectively) was observed, despite sustained clinical stability.</p><p><strong>Conclusion: </strong>This case highlights that delayed arteriovenous fistula closure may result in incomplete right heart reverse remodeling, even after symptomatic relief. Potential mechanisms include persistent hemodynamic stress from subclinical residual shunting or functional impairment due to chronic volume overload. Early intervention before irreversible right heart damage is critical for optimal outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 4","pages":"104748"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and impact of metabolically healthy obesity on cardiovascular outcomes in postmenopausal women and disparities: An age-matched study.","authors":"Adhvithi Pingili, Rupak Desai, Roopeessh Vempati, Madhusha Vemula, Mohit Lakkimsetti, Hasmitha Madhavaram, Athmananda Nanjundappa, Sandeep Singh, Praveena Sunkara, Jyotsna Gummadi","doi":"10.4330/wjc.v17.i4.105842","DOIUrl":"https://doi.org/10.4330/wjc.v17.i4.105842","url":null,"abstract":"<p><strong>Background: </strong>There is widespread debate about the impact of metabolically healthy obesity (MHO) on cardiovascular outcomes. However, studies have not exclusively examined the impact of MHO on cardiovascular outcomes in the postmenopausal population.</p><p><strong>Aim: </strong>To explore the prevalence of MHO and its relationship with hospitalization outcomes, including major adverse cardiac or cerebrovascular events (MACCE), in postmenopausal women.</p><p><strong>Methods: </strong>We extracted data from the National Inpatient Sample 2020 database using International Classification of Disease, Tenth Revision, Clinical Modification codes for all admissions of postmenopausal women. We excluded patients with diabetes, hypertension, and hyperlipidemia to obtain metabolically healthy patients and then identified patients with obesity to create obese and non-obese cohorts. We used a 1:1 propensity score matching method to match patients with and without MHO based on age, and then we did a multivariable regression analysis for in-hospital MACCE.</p><p><strong>Results: </strong>In 2020, 1304185 metabolically healthy postmenopausal women were admitted; 148250 (11.4%) had MHO. After propensity score matching for age, a statistically significant difference was observed in overall MACCE [odds ratio (OR): 1.08, 95% confidence interval (CI): 1.01-1.16, <i>P</i> = 0.028] among MHO and non-MHO cohorts, especially in patients of African-American ethnicity (OR: 1.23, 95%CI: 1.01-1.49, <i>P</i> = 0.035) and the lowermost income quartile (OR: 1.24, 95%CI: 1.06-1.44, <i>P</i> = 0.007).</p><p><strong>Conclusion: </strong>Postmenopausal patients with MHO are at risk of MACCE, especially black patients and those with lower incomes. Larger prospective studies can demystify MHO's impact on cardiovascular outcomes among postmenopausal women.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 4","pages":"105842"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sutureless aortic valve and post-operative atrial fibrillation: Five-year outcomes from a propensity matched cohort study.","authors":"Thomas French, Sanjeet Singh Avtaar Singh, Vincenzo Giordano, Charilaos-Panagiotis Koutsogiannidis, Kelvin Hao Han Lim, Renzo Pessotto, Vipin Zamvar","doi":"10.4330/wjc.v17.i4.102669","DOIUrl":"https://doi.org/10.4330/wjc.v17.i4.102669","url":null,"abstract":"<p><strong>Background: </strong>The Perceval Sorin S (perceval valve) is a sutureless bioprosthetic designed for use in a high-risk cohort who may not be suitable for transcatheter aortic valve implantation or a conventional surgical aortic valve replacement (AVR).</p><p><strong>Aim: </strong>To compare five-year post-operative outcomes in a cohort undergoing isolated AVR with the perceval valve to a contemporary cohort undergoing surgical AVR with a sutured bioprosthesis.</p><p><strong>Methods: </strong>This study was a retrospective, cohort study at a single tertiary unit. Between 2017 and 2023, 982 suitable patients were identified. 174 Perceval valve replacements were matched to 174 sutured valve replacements. Cohort characteristics, intra-operative details, and post-operative outcomes were compared between the two groups.</p><p><strong>Results: </strong>Time under the aortic cross-clamp (<i>P</i> < 0.001), time on the cardiopulmonary bypass (<i>P</i> < 0.001) and total operative time (<i>P</i> < 0.001) were significantly reduced in the Perceval group. Patients in the Perceval valve group were at a lower risk of postoperative pneumonia [odds ratio (OR) = 0.53 (0.29-0.94)] and atrial fibrillation [OR = 0.58 (0.36-0.93)]. After propensity-matching, all-cause mortality did not significantly differ between the two groups in the five-year follow-up period. Larger valve sizes conferred an increased risk of mortality (<i>P</i> = 0.020).</p><p><strong>Conclusion: </strong>Sutureless surgical AVR (SAVR) is a safe and efficient alternative to SAVR with a sutured bioprosthesis, and may confer a reduced risk of post-operative atrial fibrillation. Clinician tendency towards 'oversizing' sutureless aortic valves translates into adverse clinical outcomes. Less time on the cardiopulmonary bypass circuit allows for the treatment of otherwise high-risk patients.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 4","pages":"102669"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}