AI Article Synopsis
- Sutureless aortic valve replacement (SuAVR) is becoming more common for treating aortic stenosis, prompting a study on Canadian cardiac surgeons' views and practices.
- A survey of 66 surgeons revealed that they are more likely to choose SuAVR for high-risk patients or those with anatomical challenges, and less likely for younger patients or those with low surgical risk.
- Main barriers to using SuAVR included cost, risk of needing a permanent pacemaker, and concerns about durability, while 73% of surgeons expressed interest in participating in a trial comparing SuAVR with transcatheter aortic valve replacement.
Article Abstract
Background: Sutureless aortic valve replacement (SuAVR) is gaining popularity for the treatment of aortic stenosis. We aimed to describe Canadian cardiac surgeons' practice patterns and perceptions regarding SuAVR.
Methods: Content experts (clinicians and methodologists) developed the survey. Domains in the questionnaire include: respondent characteristics, factors influencing the decision to implant a SuAVR, barriers to SuAVR use, and interest in participating in a trial.
Results: A total of 66 cardiac surgeons (median duration of practice: 15 years; range 8-20 years) from 18 hospitals across Canada responded to the survey for a response rate of 84%. Surgeons reported that the following patient characteristics increased the likelihood they would choose SuAVR: hostile root (73%), small annular size (55%), high Society of Thoracic Surgery risk score (42%), older age (40%), to support minimally invasive surgery (25%) and redo-operation (23%). The following patient characteristics made surgeons less likely to pursue SuAVR: young age (73%), low STS score (40%), and large annular size (30%). Reported barriers to SuAVR use included: cost (33%), permanent pacemaker risk (27%) and uncertain durability (12%). Of respondents, 73% were interested in participating in a randomized controlled trial comparing SuAVR with transcatheter aortic valve replacement.
Conclusions: The primary reasons for surgeons selecting SuAVR were high surgical risk and anatomical challenges. Cost is a primary factor limiting SuAVR use.
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| http://dx.doi.org/10.1111/jocs.16839 | DOI Listing |
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