Severe aortic stenosis represents a growing worldwide problem. It is the most common valvular disease and affects 2% of the population older than 65 years. After the onset of symptoms, average survival is 2-3 years. Aortic valve replacement is the treatment of choice but recent data suggests that approximately one third of the patients are not candidates for surgery because of high operative risk. Sutureless implantation is perceived to constitute an alternative treatment because it has the potential to shorten cardiopulmonary bypass (CPB) and cross clamp time.

Objectives
The main objective is to assess effectiveness, safety and economic impact of sutureless aortic valve replacement. The specific objectives are:

 1) assess the potential benefit-risk balance in comparison to surgical aortic valve replacement

2) assess the potential benefit-risk balance against transcatheter
aortic-valve implantation (TAVI).

 

A systematic search was carried out in the main literature and clinical
research databases (PubMed, Embase, Cochrane, ISI Web of Knowledge, Centre for Reviews and Recommendations, Cochrane, etc.). Internet was scanned and manufactures contacted to recover non published information.
The studies were selected by two independent reviewers based on a set of predefined selection criteria. Data was extracted using a data extraction form and synthesized qualitatively in the form of evidence tables. The methodological quality of the studies was assessed using the SIGN scale.

 

Results, discussion and conclussion: See pdf below