title: Perceval sutureless aortic valve prosthesis: easy, fast, and safe.
abstract: OBJECTIVE
  There is an increase of old patients needing aortic valve surgery. Especially in this age group, a lot of new less-invasive strategies are proposed. Our goal was to study whether a sutureless aortic valve, which is implanted surgically after removal of the native valve, could be an alternative for a subgroup of patients.
  
  
  METHODS
  The Sorin Perceval S is a biologic pericardial aortic valve assembled in a metal super elastic alloy stent and implanted in the aortic root without the need of suturing. As part of a premarketing multicenter study (Cavalier trial), 34 patients were screened for Perceval S implantation. All patients underwent cardiopulmonary bypass and mini-invasive approach (partial upper sternotomy).
  
  
  RESULTS
  Fourteen patients were excluded due to standardized criteria. Twenty patients received a 21-mm valve (2 patients), 23-mm valve (6 patients), or 25-mm valve (12 patients). X-clamp time was 20.6 ± 7.6 minutes, and implantation time was 8.6 ± 3.1 minutes. Intra- and postoperative echocardiography showed no paravalvular leakage, low gradients (max 16.3 ± 5, mean 9.8 ± 4.2), and two patients with an intraprosthesis reflux (one patient with 1/4+, one patient with 2/4+). All patients were discharged without major in-hospital complications (intensive care unit stay 1.4 ± 0.5 days, hospital stay 7 ± 0.7 days).
  
  
  CONCLUSIONS
  The sutureless Perceval S aortic valve is hemodynamically excellent and a safe prosthesis in selected patients. Due to a simple and fast implantation technique, this valve could guarantee a shorter operation time in combination with a mini-invasive approach.
authors.affiliation: Department of Cardiac Surgery, Klinikum Nürnberg, Nuremberg, Germany. g.santarpino@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.forename: Steffen
authors.initials: S
authors.lastname: Pfeiffer
authors.forename: Giovanni
authors.initials: G
authors.lastname: Concistrè
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein