The Heart Surgery Forum (HSF) is published by IMR Press from Volume 28 Issue 8 (2025). Previous articles were published by another publisher under the CC-BY-NC licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement.
Sutureless and Trans-catheter Valve Use in Aortic Valve Endocarditis:A Review
1 Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH 44195, USA
2 Department of Infectious Disease, Cleveland Clinic, Cleveland, OH 44195, USA
3 Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
*Correspondence: Elgharh@ccf.org (Haytham Elgharably)
Abstract
New approaches have been developed to treat aortic valve disease, including sutureless and trans-catheter aor-tic valve replacement (TAVR). Few groups have reported their experience using sutureless and trans-catheter valves for aortic valve endocarditis. We aim to review the current available data on the application of these two approaches in managing aortic valve endocarditis. A literature search was conducted on PubMed, EBSCOhost, and Google scholar databases using the following search terms: “Perceval en-docarditis”; “sutureless valve endocarditis”; “Intuity valve endocarditis”; “TAVR endocarditis”; “percutaneous aortic valve endocarditis”; “Trans-catheter valve endocarditis”. After filtering, we found 26 articles appropriate for our re-view including 20 articles about sutureless valves for en-docarditis (16 Perceval, 4 Intuity), and 6 articles on trans-catheter aortic valve implantation for endocarditis. The ob-served early mortality rate of sutureless valve implantation in aortic valve endocarditis ranged between 14–23%, while early mortality rates in a recent national sample of the stan-dard surgical approach were between 8–10%. Additionally, there was an observed increased incidence of peri-valvular aortic regurgitation after sutureless valve implantation for endocarditis. We observed an increased risk of stroke for trans-catheter implantation in aortic valve endocarditis with large vegetations. The current evidence suggests caution for the implantation of trans-catheter and sutureless valves in patients with aortic valve endocarditis. High risk patients for the standard surgical approach or complex endocarditis cases should be evaluated through a multidisciplinary en-docarditis team at specialized centers.
Keywords
- aortic valve
- endocarditis
- sutureless valve
- trans-catheter valve
