Continuous suture technique in surgical aortic valve replacement: early and mid-term outcomes in a real-world cohort including combined procedures

Abstract

The continuous suture technique is not routinely used in surgical aortic valve replacement (SAVR), and data regarding its clinical outcomes remain limited. This retrospective observational study evaluated early and mid-term outcomes after continuous suture SAVR in a real-world cohort. Eighty-eight consecutive patients who underwent SAVR using a continuous suture technique between November 2015 and July 2024 were included. Both isolated and concomitant procedures were analyzed. The operative technique consisted of three 2-0 polypropylene sutures, one placed along each aortic cusp. Clinical outcomes, postoperative complications, and survival were assessed. The mean age was 62.22 ± 15.22 years, and 71.6% of patients were male. Bioprosthetic valves were implanted in 61.4% of cases, and the mean prosthesis size was 25.02 ± 0.93 mm. Concomitant procedures were performed in 86.4% of patients. There were no in-hospital deaths. New-onset atrial fibrillation occurred in 26.1% of patients, and permanent pacemaker implantation was required in 3.4%. The median cross-clamp time was 41.50 min. During a mean follow-up of 18.38 months, one- and three-year overall survival was 92.9%. No prosthetic valve dysfunction related to thrombus, pannus formation, or clinically significant paravalvular leak was observed. Continuous suture SAVR appears feasible and safe, with acceptable early and mid-term outcomes, although the retrospective, non-comparative design requires cautious interpretation.