{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:16:44Z","timestamp":1760145404375,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: In an era of growing evidence for transaortic valve implantation (TAVI), our research topic was the evaluation of how surgical aortic valve replacements (SAVRs) are performing in terms of short- and long-term outcomes in different risk categories. Methods: This was a single centre, prospective, and observational cohort study of consecutive patients with aortic valve stenosis, undergoing isolated aortic valve replacement using a biological or mechanical prosthesis, Freestyle\u2122 (Medtronic, Minneapolis, MN, USA) graft, homograft, or Ross procedure. The participant data were collected by review of an internal database. The primary endpoints were all-cause operative mortality (in hospital and at 30 days) and late mortality at the follow-up date. The secondary composite endpoint was the incidence of postoperative complications. Results: 1501 patients underwent SAVR; the mean age was 67 years (SD: 12.6). The in-hospital mortality was 1% (n = 16). At a median follow-up of 60 months, the survival rate was 98.7%. The main predictors for mortality were operative urgency and cardiogenic shock. The overall incidence of PPM was 2.3% (n = 34). Patients who underwent Ross procedure were younger (mean age: 20 years (SD: 1.7)), had a lower incidence of postoperative complications, and were all alive at follow-up. Conclusions: SAVR shows an excellent survival rate and a low rate of postoperative complications despite an increasing surgical risk. Recent advancements in technology, like sutureless\/rapid deployment prostheses and minimally invasive techniques, are shown to have favourable effects on outcomes.<\/jats:p>","DOI":"10.3390\/jcm13144126","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T14:15:49Z","timestamp":1721052949000},"page":"4126","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel Techniques and Technologies for Surgical Aortic Valve Replacement: A Large Retrospective Cohort Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Vincenzo","family":"Caruso","sequence":"first","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5866-9001","authenticated-orcid":false,"given":"Rajdeep","family":"Bilkhu","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Young","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Bosco","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8444-6840","authenticated-orcid":false,"given":"Gianluca","family":"Lucchese","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/j.jacc.2014.02.536","article-title":"2014 AHA\/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Nishimura","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2714","DOI":"10.1161\/CIRCULATIONAHA.118.036606","article-title":"Five-year clinical and echocardiographic outcomes from the NOTION randomized clinical trial in patients at lower surgical risk","volume":"139","author":"Thyregod","year":"2019","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"SURTAVI Investigators. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Evolut Low Risk Trial Investigators. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"PARTNER 3 Investigators. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_6","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"ref_7","first-page":"561","article-title":"ESC\/EACTS Scientific Document Group, 2021 ESC\/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"43","author":"Beyersdorf","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1093\/eurheartj\/ehy774","article-title":"Transcatheter aortic valve implantation in patients with longer life expectancy: What measures are needed?","volume":"40","author":"Sondergaard","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1016\/j.jacc.2019.06.076","article-title":"Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients","volume":"74","author":"Kolte","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.amjcard.2019.10.036","article-title":"Meta-Analysis of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients with Low Surgical Risk","volume":"125","author":"Vipparthy","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1093\/icvts\/ivx294","article-title":"Sutureless aortic valve replacement versus transcatheter aortic valve implantation: A meta-analysis of comparative matched studies using propensity score matching","volume":"26","author":"Meco","year":"2018","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jtcvs.2020.11.162","article-title":"Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement Investigators. 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":"ref_13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1055\/s-0038-1675847","article-title":"Sutureless versus Stented Bioprostheses for Aortic Valve Replacement: The Randomized PERSIST-AVR Study Design","volume":"68","author":"Lorusso","year":"2020","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1111\/jocs.14607","article-title":"Mini-sternotomy vs. right anterior thoracotomy for aortic valve replacement","volume":"35","author":"Hamilton","year":"2020","journal-title":"J. Card. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.athoracsur.2018.07.018","article-title":"Minimally Invasive Approaches to Surgical Aortic Valve Replacement: A Meta-Analysis","volume":"106","author":"Chang","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1253\/circj.CJ-19-0674","article-title":"Japan Cardiovascular Surgery Database Organization. Contemporary Outcomes of Surgical Aortic Valve Replacement in Japan","volume":"84","author":"Tokuda","year":"2020","journal-title":"Circ. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1053\/j.semtcvs.2020.07.013","article-title":"Quality of Life After Ministernotomy Versus Full Sternotomy Aortic Valve Replacement","volume":"33","author":"Porras","year":"2021","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1111\/jocs.15209","article-title":"Patient survival in severe low-flow, low-gradient aortic stenosis after aortic valve replacement or conservative management","volume":"36","author":"Micali","year":"2021","journal-title":"J. Card. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"s28","DOI":"10.1136\/heartjnl-2018-313515","article-title":"Patient-prosthesis mismatch following aortic valve replacement","volume":"105","author":"Bilkhu","year":"2019","journal-title":"Heart"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/eurheartj\/9.suppl_E.57","article-title":"The natural history of aortic valve stenosis","volume":"9","author":"Horstkotte","year":"1988","journal-title":"Eur. Heart J."},{"key":"ref_21","first-page":"268","article-title":"Meta-analysis of the impact of intervention versus symptom-driven management in asymptomatic severe aortic stenosis","volume":"103","author":"Lim","year":"2017","journal-title":"Heart (Br. Card. Soc.)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.hlc.2006.06.001","article-title":"Echocardiographic prevalence of bicuspid aortic valve in the population","volume":"15","author":"Movahed","year":"2006","journal-title":"Heart Lung Circ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/S0140-6736(20)30530-4","article-title":"An alarming rise in incidence of infective endocarditis in England since 2009: Why?","volume":"395","author":"Thornhill","year":"2020","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kvaslerud, A.B., Santic, K., Hussain, A.I., Auensen, A., Fiane, A., Skulstad, H., Aaberge, L., Gullestad, L., and Broch, K. (2021). Outcomes in asymptomatic, severe aortic stenosis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249610"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"996","DOI":"10.29271\/jcpsp.2019.10.996","article-title":"Emergent Transcatheter Aortic Valve Implantation as a Life-saving Procedure: A Primary Treatment Approach","volume":"29","author":"Ozdemir","year":"2019","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1002\/ccr3.3732","article-title":"Emergency TAVI in a critically ill patient: A case report","volume":"9","author":"Papadopoulos","year":"2020","journal-title":"Clin. Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e001467","DOI":"10.1136\/openhrt-2020-001467","article-title":"Patients\u2019 characteristics and mortality in urgent\/emergent\/salvage transcatheter aortic valve replacement: Insight from the OCEAN-TAVI registry","volume":"7","author":"Enta","year":"2020","journal-title":"Open Heart"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/j.athoracsur.2016.12.050","article-title":"Pacemaker implantation rate post suture- less aortic valve replacement: 23% is just too high","volume":"104","author":"Booth","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jtcvs.2016.03.055","article-title":"How to prevent a pace- maker implantation after sutureless bioprosthesis","volume":"152","author":"Fischlein","year":"2016","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.athoracsur.2016.11.013","article-title":"How to prevent pacemaker implantation after sutureless aortic valve replacement: Tips and tricks","volume":"104","author":"Vogt","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/j.cjca.2013.08.009","article-title":"What is the role of the Ross procedure in today\u2019s armamentarium?","volume":"29","author":"Hamamsy","year":"2013","journal-title":"Can. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/ejcts\/ezy247","article-title":"The Ross procedure versus prosthetic and homograft aortic valve replacement: A systematic review and meta-analysis","volume":"55","author":"McClure","year":"2019","journal-title":"Eur. J. Cardiothorac. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/14\/4126\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:17:06Z","timestamp":1760109426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/14\/4126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":32,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13144126"],"URL":"https:\/\/doi.org\/10.3390\/jcm13144126","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,7,15]]}}}