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A Meta-analysis Examining the Incidence of Permanent Pacemaker Implantation Following Sutureless Aortic Valve Implantation
Katie E. O' Sullivan1, Eoghan T. Hurley1, Ricardo Segurado2, John P. Hurley1.
1Mater Private Hospital, Dublin, Ireland, 2CSTAR Centre for Statistical Training and Research, University College Dublin, Dublin, Ireland.

OBJECTIVE: Sutureless aortic valve prostheses are anchored by radial force in a mechanism similar to that of transcatheter aortic valve implantation (TAVI). TAVI is associated with an increased permanent pacemaker (PPM) requirement in a significant proportion of patients. We undertook a meta-analysis to examine the incidence of PPM insertion associated with sutureless compared with conventional surgical aortic valve replacement (SAVR).
METHODS: A systematic review was conducted in accordance with the Prisma guidelines (1). PubMed was searched by entering the following in the searching algorithm: sutureless AND aortic AND valve, tissue AND aortic AND valve, mechanical AND aortic AND valve. English was set as a language restriction. All searches were performed on August 10th 2014. Studies between 2007 and 2014 were included in the search.
RESULTS: In total, 832 patients were included in the sutureless group and 3,740 in the conventional group. Permanent pacemaker implantation rate was higher in the sutureless cohort (9.1 vs 2.4% p=0.025).
CONCLUSIONS: Sutureless aortic valve prostheses are associated with a higher incidence of PPM insertion than conventional. Further investigation as to the prognostic significance of pacemaker requirement following sutureless aortic valve replacement is required.

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