Evidence map›Paper›PMID 36820352›Full record

ArticleJTCVS techniques2023

Pledgeted versus nonpledgeted sutures in aortic valve replacement: Insights from a prospective multicenter trial.

Bart J J Velders, Michiel D Vriesendorp, Joseph F Sabik, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Gabriel S Aldea, Anelechi C Anyanwu, Yaping Cai, Robert J M Klautz

Open access · goldAbstract read
In one paragraph

Article in JTCVS techniques, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 4 countries.

Bart J J VeldersDepartment of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
Michiel D VriesendorpDepartment of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
Joseph F SabikDepartment of Surgery, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Francois DagenaisDivision of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec, Quebec, Canada.
Louis LabrousseMedico-Surgical Department of Valvulopathies, Bordeaux Heart University Hospital, Bourdeaux-Pessac, France.
Vinayak BapatDepartment of Cardiothoracic Surgery, NHS Foundation Trust-St Thomas' Hospital, London, United Kingdom.
Gabriel S AldeaDepartment of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Wash.
Anelechi C AnyanwuDepartment of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
Yaping CaiCore Clinical Solutions, Medtronic, Mounds View, Minn.
Robert J M KlautzDepartment of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
Leiden University · NLIcahn School of Medicine at Mount Sinai · USMedtronic (United States) · USMontreal Heart Institute · CASt Thomas' Hospital · GBUniversity of Washington · USUniversity School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The objective of this study was to compare short- and midterm clinical and echocardiographic outcomes according to the use of pledgeted sutures during aortic valve replacement. Methods: Patients with aortic stenosis or regurgitation requiring aortic valve replacement were enrolled in a prospective cohort study to evaluate the safety of a new stented bioprosthesis. Outcomes were analyzed according to the use of pledgets (pledgeted group) or no pledgets (nonpledgeted group). The primary outcome was a composite of thromboembolism, endocarditis, and major paravalvular leak at 5 years of follow-up. Secondary outcomes included multiple clinical endpoints and hemodynamic outcomes. Propensity score matching was performed to adjust for prognostic factors, and subanalyses with small valve sizes (<23 mm) and suturing techniques were performed. Results: The pledgeted group comprised 640 patients (59%), and the nonpledgeted group 442 (41%), with baseline discrepancies in demographic characteristics, comorbidities, and stenosis severity. There were no differences between groups in any outcome. After propensity score matching, the primary outcome occurred in 41 (11.7%) patients in the pledgeted and 36 (9.8%) in the nonpledgeted group ( Conclusions: In this large propensity score-matched cohort, comprehensive clinical outcomes were comparable between patients who underwent aortic valve replacement with pledgeted and nonpledgeted sutures up to 5 years of follow-up, but pledgets might lead to a slightly smaller effective orifice area in the long run.

Indexed as

AVR, aortic valve replacementBMI, body mass indexBSA, body surface areaendocarditisEOA, effective orifice areaEOAi, effective orifice area indexedLVOT, left ventricular outflow tractparavalvular leakPERIGON, PERIcardial SurGical AOrtic Valve ReplacemeNtpledgetsPPM, prosthesis–patient mismatchPVL, paravalvular leakSTS, Society of Thoracic Surgeonssurgical aortic valve replacementsuturing techniquethromboembolism

Identifiers

PMID36820352
PMCPMC9938379
OpenAlexW4308309070

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.