Surgical sutureless and transcatheter aortic valves: hemodynamic performance and clinical outcomes in propensity score-matched high-risk populations with severe aortic stenosis.

In this manuscript the authors describe their findings in an observational study of patients undergoing either aortic valve replacement with a “sutureless” aortic valve bioprosthesis (Medtronic’s 3f Enable) or transcatheter aortic valve implantation (TAVI) with either an Edwards Sapiens XT or Medtronic CoreValve prosthesis, comparing functional and clinical outcomes. Propensity score matching (80 patients) was performed to control  selection bias.The findings suggest that transcatheter bioprostheses have a better hemodynamic profile than the 3f Enable valve in terms of effective orifice area index and mean transvalvular pressure gradient. However, aortic regurgitation was present more often after TAVI. The sutureless bioprosthesis was independently associated with patient-prosthesis mismatch at discharge. Nevertheless, these hemodynamic differences had no impact on the mid-term survival of the patients.