Early Outcomes of Aortic Valve Replacement with Sutureless and Rapid Deployment Prostheses in Dialysis Patients

Background: Although sutureless aortic valve replacement is rising in popularity, there are few reports on its use in patients on dialysis. This study aimed to investigate the early and mid-term surgical outcomes of the procedure in these patients. Methods: Twenty-one dialysis (mean age, 77.4 ± 5.2 years) patients with aortic stenosis who underwent aortic valve replacement with sutureless and rapid deployment prostheses between May 2019 and March 2021 were enrolled. We retrospectively reviewed and analyzed the clinical courses of all dialysis patients. Data on patient characteristics, surgical procedures, and postoperative outcomes (survival times and major adverse cardiac and cerebrovascular events) were collected. The mean follow-up duration was 371 days (interquartile range (IQR) 364–399). Results: Two (9.5%) operative deaths occurred within 30 days of surgery. The 1-year survival was 85.7%, and the rates of freedom from cardiac death, myocardial infarction, and stroke were 95.0%, 89.7%, and 95.0%, respectively. 1 year freedom from major adverse cardiac and cerebrovascular events was 67.8%. There was one (5.5%) permanent pacemaker implantation 9 months after surgery. No reoperations were performed for any cause. Three patients had moderate prosthesis-patient mismatch 4–7 days after surgery. Effective orifice area index improved from 0.74 cm2/m2 to 0.87 cm2/m2 in one patient 1 year after surgery. No cases of structural valve deterioration or a paravalvular leak were observed. Conclusions: Sutureless aortic valve replacement in dialysis patients may be a novel treatment strategy with lower early mortality rates comparable to those of conventional treatments, increased freedom from pacemaker implantation, and good valve function.