Sutureless versus transcatheter aortic valve replacement: propensity matched analysis

Abstract 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   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. Keywords: Aortic valve replacement, aortic valve stenosis, sutureless aortic valve replacement, transcatheter aortic valve replacement, propensity score matching.