Fatih Öztürk1, Taylan Adademir2, Veysel Başar2, Osman Türe1, Davut Çekmecelioğlu3, Mehmet Şengör1, Hızır Mete Alp4

1University of Marmara, Pendik Training and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
2University of Health Sciences, Istanbul Kartal Kosuyolu High Speciality Training and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
3Baylor College of Medicine, Houston, TX, Division of Cardiothoracic Surgery, Michael E. Debakey Department of Surgery, Houston, TX, United States of America
4University of Okan, Faculty of Medicine, Department of Cardiovascular Surgery, Istanbul, Turkey

Keywords: Aortic stenosis, aortic valve replacement (AVR), sutureless aortic valve


Introduction: This study aimed to evaluate the early and midterm results of sutureless and conventional bioprosthetic valves in patients who underwent aortic valve replacement (AVR) due to aortic stenosis.

Patients and Methods: Patients who underwent a bioprosthetic AVR due to aortic stenosis in our institution between 2012 and 2017 were included in our study. The patients were divided into two groups on the basis of type of aortic valve prosthesis used as a sutureless valve (SU-AVR) (n= 62) and a conventional valve (CAVR) (n= 69).

Results: The EuroSCORE II in the sutureless group was found to be significantly higher as compared to the conventional group (p= 0.0121). Patients in the sutureless group underwent more mini-incisional approaches: 22 (36%) versus 4 (6%, p= 0.0002). The mean aortic cross-clamp and cardiopulmonary bypass time were significantly lower in the sutureless group as compared to the conventional one (53.8 ± 34.2 vs. 79.2 ± 36.3 minutes and 87.5 ± 40.7 vs. 117.4 ± 66.3 minutes, p< 0.0001). The mean follow-up time was 19.5 ± 15.7 months in the sutureless group and 28.0 ± 21.0 months in the conventional group. The overall survival rate of the sutureless and the conventional group was found to be 72.6% and 78.3%, respectively, (p= 0.253) when Kaplan-Meier analysis was done.

Conclusion: Although SU-AVR patients are found to have a higher preoperative risk score compared to the conventional group, yet it can be performed with comparable mortality and morbidity to C-AVR. Therefore, SUAVR is a promising alternative to C-AVR, especially in elderly and high-risk patients with comorbid diseases.

Ethics Committee Approval

The study was approved by the Department of Ethics of Maltepe University (No: 2016/900/09, Date: 15/04/2016).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - FÖ, TA, HMA; Analysis/ Interpretation - FÖ, TA; Data Collection - FÖ, DÇ, MŞ; Writing - FÖ, OT; Critical Revision -TA, VB; Final Approval - FÖ; Statistical Analysis - FÖ, TA; Overall Responsibility - FÖ, TA, HMA.

Conflict of Interest

The authors declared that there was no conflict of interest during the preparation and publication of this article.

Financial Disclosure

The authors declared that this study has received no financial support.