Sutureless aortic valves over the last 45 years

Degenerative and calcified aortic stenosis is the most common form of adult valvular heart disease, and surgical aortic valve replacement (AVR) with the use of extracorporeal circulation (ECC) is currently the method of choice which can be performed at low risk. However, older patients with multiple pre-existing 'high-risk' comorbid conditions may benefit from reduced ECC time and thus reduced myocardial ischemia by the use of minimally invasive or interventional aortic valve implantation. Therefore, a sutureless concept of aortic valve implantation came up in the early sixties. However, this innovative concept of sutureless heart valve implantation was abandoned again due to several disadvantages. To date, there is a growing need for fast sutureless implantation of valve prostheses due to an increase in comorbidities. New challenging fields in aortic valve surgery have been recently rediscovered followed by an improvement of the sutureless valve implantation technique. Therefore, we reviewed the current and historical literature describing valve design and materials, as well as clinical data based on valve-related complications or morbidity/mortality.