Sutureless versus transcatheter aortic valve replacement: propensity matched analysis.

Background: The goal of this study is to perform a propensity score matched analysis of sutureless AVR and TAVR to compare patient characteristics and postoperative outcomes including hemodynamic performance.

Methods: Patients treated with either sutureless aortic valve replacement (SU-AVR) using Perceval^TM or transcatheter aortic valve replacement between October 2017 and June 2022 were included. Propensity score matching (PSM) was used to limit the bias in a non-randomized study.

Results: After PSM, 118 pairs of patients were obtained. The in-hospital mortality rate was 0% in SU-AVR and 4.2% in TAVR (p = 0.063). Postoperative complication rates including disabling stroke (0% vs 2.5%, p = 0.250), new need for dialysis (1.7% vs 0%, p = 0.500), and permanent pacemaker implantation at 30 days (5.9% vs 10.2%, p = 0.332) showed no statistical difference. At discharge, TAVR showed significantly lower peak and mean gradients, while paravalvular leakage higher than 1/4 was significantly higher in TAVR (11% vs 0%, p < 0.001).

Conclusions: TAVR offers significantly better transprosthetic gradients, shorter ICU and hospital stays, and less need for postoperative dialysis. Surgery using a sutureless valve showed less paravalvular leakage.