Minimally invasive aortic valve replacement using the Perceval S sutureless valve.

The term “sutureless aortic valve” (su-AV) describes a type of valve which facilitates anchoring of bioprostheses in the aortic position without use of conventional sutures. Although all valve prostheses used for transcatheter aortic valve implantation or replacement (TAVI or TAVR) follow the same principle, they are implanted by wire-based techniques as opposed to su-AVs, which are implanted by conventional surgical techniques. Because all commercially available su-AVs are not all truly sutureless, another general term “rapid deployment valve” has also been used. There are three commercial available su-AV substitutes (Figure 1), the 3F Enable (Medtronic, Minneapolis, USA), the Perceval S (Sorin, Saluggia, Italy), and the Intuity valve (Edward Lifesciences, Irvine, USA). These valves are implanted after excision of the native aortic valves and decalcification of the aortic annulus. So far, these valves are used only in patients with aortic stenosis or combined aortic valve disease. Isolated aortic regurgitation is currently not an indication for su-AVs.