[Aortic valve replacement with rapid deployment or sutureless valves]

Larrea Bonavento N, Alcaraz A, Pichon-Riviere A, Augustovski F, García Martí S, Bardach A, Ciapponi A.
Record ID 32018001508
Original Title: Reemplazo valvular aórtico con válvulas de despliegue rápido o sin sutura
Authors' recommendations: CONCLUSIONS Moderate-quality evidence suggests that aortic valve replacement with rapid deployment or sutureless bioprostheses has results similar to those of conventional valves in terms of early and during follow-up mortality, as well as in moderate/severe paravalvular leak, acute kidney failure and stroke. Their use would be associated to a greater requirement for permanent pacemaker, less aortic clamp time and a greater percentage of minimally invasive surgery. Low-quality evidence may suggest that aortic valve replacement with rapid deployment or sutureless bioprostheses in moderate/high surgical risk patients might be associated with a decrease in early mortality and at two years when compared to TAVI. Regarding their safety profile, evidence suggests better results in paravalvular leaks, major vascular complications and risk of stroke, with no differences in acute kidney failure, permanent pacemaker requirement and length of stay at the intensive care unit. No evidence was found that may allow clear identification of the group of patients who may benefit the most from this technology. Patient selection should be performed on a case by case base by a multidisciplinary team. Some clinical practice guidelines assessed, include it as an alternative procedure to conventional surgery, whereas others do not mention this technology. Most health sponsors surveyed do not cover it. Only the United States and British state health sponsors consider its use. No cost-effectiveness studies or budget impact analysis were found in Argentina.
Project Status: Completed
Year Published: 2018
URL for published report: https://www.iecs.org.ar/home-ets/
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Aortic Valve Stenosis
  • Heart Valve Prosthesis Implantation
  • Transcatheter Aortic Valve Replacement
  • Heart Valve Prosthesis
  • Sutureless Surgical Procedures
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.