{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:52:15Z","timestamp":1791449535755,"version":"4.3.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Aortic valve replacement with a sutureless prosthesis [sutureless aortic valve replacement (Su-AVR)] is an option for patients with severe aortic valve stenosis. However, data regarding long-term outcomes and prosthesis durability are still lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All consecutive patients who successfully underwent Su-AVR with the Perceval valve in our centre between 2010 and 2020 were included in the analysis and followed prospectively with echocardiography. Risk factor analysis was performed to assess variables associated with worse survival and bioprosthetic valve failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Study population consisted of 547 patients: the mean age was 76.4 (5.2) years, 51% were female and the mean logistic EuroSCORE was 13% (11). The median survival was 7.76\u2009years [95% confidence interval (CI)\u2009=\u20096.9\u20138.6]. Risk factor analysis identified age [hazard ratio (HR) 1.06, 95% CI 1.03\u20131.11; P\u2009&amp;lt;\u20090.001), EuroSCORE II (HR 1.08, 1.02\u20131.13; P\u2009&amp;lt;\u20090.001), baseline dialysis (HR 2.14, 95% CI 1.4\u20134.4; P\u2009=\u20090.038) and postoperative acute kidney injury \u22652 (HR 8.97, 95% CI 4.58\u201317.6; P\u2009&amp;lt;\u20090.001) as factors significantly correlated with worse survival. The reported HRs for age are per 1 year and for EuroSCORE II is 1 percentage point. Structural valve deterioration (SVD) was observed in 23 patients, of whom 19 underwent reintervention (median freedom from SVD 10.3\u2009years). In multivariable Cox analysis, age (HR 0.89, 95% CI 0.82\u20130.95; P\u2009&amp;lt;\u20090.001) was found to be a significant predictor of SVD. Overall, 1.8% was referred for prosthetic valve endocarditis (confirmed or suspected) during follow-up. One patient showed moderate non-SVD and none developed prosthetic valve thrombosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The sutureless valve represents a reliable bioprosthesis for aortic valve replacement in patients with a 10-year life expectancy. Younger age at the time of implant is the only factor associated with the risk of long-term SVD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac572","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T23:34:48Z","timestamp":1671233688000},"source":"Crossref","is-referenced-by-count":22,"title":["Ten years\u2019 experience with the sutureless aortic valve replacement: incidence and predictors for survival and valve durability at follow-up"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-532X","authenticated-orcid":false,"given":"Francesco","family":"Pollari","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem","family":"Mamdooh","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Hitzl","sequence":"additional","affiliation":[{"name":"Research and Innovation Management (RIM) Department, Biostatistics and Publication of Clinical Trials, Paracelsus Medical University , Salzburg, Austria"},{"name":"Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg , Salzburg, Austria"},{"name":"Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University , Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-6823","authenticated-orcid":false,"given":"Ferdinand","family":"Vogt","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-3590","authenticated-orcid":false,"given":"Theodor","family":"Fischlein","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"2023021412420264900_ezac572-B1","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1093\/eurheartj\/ehx141","article-title":"Mechanical versus bioprosthetic aortic valve replacement","volume":"38","author":"Head","year":"2017","journal-title":"Eur Heart J"},{"key":"2023021412420264900_ezac572-B2","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.athoracsur.2014.04.072","article-title":"Better short-term outcome by using sutureless valves: a propensity-matched score analysis","volume":"98","author":"Pollari","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B3","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jtcvs.2020.11.162","article-title":"Sutureless versus conventional bioprostheses for aortic valve replacement in severe symptomatic aortic valve stenosis","volume":"161","author":"Fischlein","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023021412420264900_ezac572-B4","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1016\/j.jtcvs.2020.12.109","article-title":"Midterm outcomes with a sutureless aortic bioprosthesis in a prospective multicenter cohort study","volume":"164","author":"Fischlein","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023021412420264900_ezac572-B5","doi-asserted-by":"crossref","first-page":"265","DOI":"10.21037\/acs-2020-surd-25","article-title":"Long-term outcomes of sutureless and rapid-deployment aortic valve replacement: a systematic review and meta-analysis","volume":"9","author":"Williams","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"key":"2023021412420264900_ezac572-B6","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/j.athoracsur.2020.06.064","article-title":"Perceval sutureless aortic valve implantation: midterm outcomes","volume":"111","author":"Szecel","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B7","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/ejcts\/ezx244","article-title":"Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"52","author":"Capodanno","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023021412420264900_ezac572-B8","doi-asserted-by":"crossref","first-page":"c179","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron Clin Pract"},{"key":"2023021412420264900_ezac572-B9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.athoracsur.2018.12.037","article-title":"Sutureless aortic valve and pacemaker rate: from surgical tricks to clinical outcomes","volume":"108","author":"Vogt","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B10","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ejcts\/ezab389","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"60","author":"Vahanian","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023021412420264900_ezac572-B11","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.jtcvs.2018.08.085","article-title":"Risk factors for paravalvular leak after transcatheter aortic valve replacement","volume":"157","author":"Pollari","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023021412420264900_ezac572-B12","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jcct.2019.12.001","article-title":"Aortic valve calcification as a risk factor for major complications and reduced survival after transcatheter replacement","volume":"14","author":"Pollari","year":"2020","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2023021412420264900_ezac572-B13","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.athoracsur.2018.01.066","article-title":"Acute kidney injury classification underestimates long-term mortality after cardiac valve operations","volume":"106","author":"Bouma","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B14","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/icvts\/ivab034","article-title":"Improved creatinine-based early detection of acute kidney injury after cardiac surgery","volume":"33","author":"Vogt","year":"2021","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2023021412420264900_ezac572-B15","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/ejcts\/ezab470","article-title":"Long-term durability after surgical aortic valve replacement with the Trifecta and the Intuity valve-a comparative analysis","volume":"61","author":"Werner","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023021412420264900_ezac572-B16","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1016\/j.jtcvs.2019.11.028","article-title":"Durability and clinical experience using a bovine pericardial prosthetic aortic valve","volume":"161","author":"Lehmann","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023021412420264900_ezac572-B17","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.athoracsur.2020.07.040","article-title":"Durability and performance of 2298 Trifecta aortic valve prostheses: a propensity-matched analysis","volume":"111","author":"Yongue","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B18","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.athoracsur.2014.09.030","article-title":"Very long-term outcomes of the Carpentier-Edwards Perimount valve in aortic position","volume":"99","author":"Bourguignon","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2023021412420264900_ezac572-B19","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/j.jacc.2018.01.059","article-title":"Long-term outcomes following surgical aortic bioprosthesis implantation","volume":"71","author":"Rodriguez-Gabella","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2023021412420264900_ezac572-B20","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1093\/ejcts\/ezy459","article-title":"Biological or mechanical prostheses for isolated aortic valve replacement in patients aged 50-65 years: the ANDALVALVE study","volume":"55","author":"Rodr\u00edguez-Caulo","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023021412420264900_ezac572-B21","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.jcin.2019.10.030","article-title":"Transcatheter ViV versus redo surgical AVR for the management of failed biological prosthesis: early and late outcomes in a propensity-matched cohort","volume":"13","author":"Tam","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2023021412420264900_ezac572-B22","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1016\/j.jacc.2021.09.861","article-title":"Life expectancy after surgical aortic valve replacement","volume":"78","author":"Martinsson","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2023021412420264900_ezac572-B23","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jtcvs.2018.01.099","article-title":"A novel tissue treatment to reduce mineralization of bovine pericardial heart valves","volume":"156","author":"Meuris","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023021412420264900_ezac572-B24","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1056\/NEJMoa1911426","article-title":"Reduced leaflet motion after transcatheter aortic-valve replacement","volume":"382","author":"De Backer","year":"2020","journal-title":"N Engl J Med"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezac572\/48174108\/ezac572.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/2\/ezac572\/49175350\/ezac572.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/2\/ezac572\/49175350\/ezac572.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T12:50:20Z","timestamp":1676379020000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac572\/6935788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,19]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac572","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2022,12,19]]},"article-number":"ezac572"}}