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Updated: May 6, 2026
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Two alternative sutureless strategies for aortic valve replacement: a two-center experience
Giovanni Concistrè1, Giuseppe Santarpino, Steffen Pfeiffer
1From the *Department of Cardiac Surgery - Klinikum Nürnberg, Nuremberg, Germany; and †Department of Cardiac Surgery, Ospedale del Cuore "G. Pasquinucci," Fondazione Monasterio-CNR, Massa, Italy.
Sutureless aortic bioprostheses, including the Perceval S and 3f Enable, are feasible for aortic valve replacement (AVR), even with minimally invasive techniques. The Perceval S demonstrated shorter operative times and better hemodynamic performance compared to the 3f Enable.
Area of Science:
- Cardiovascular Surgery
- Biomaterials in Medicine
Background:
- Patients undergoing aortic valve replacement (AVR) often have comorbidities necessitating less invasive surgical strategies.
- Sutureless bioprostheses offer a potential solution for complex AVR cases.
Purpose of the Study:
- To evaluate the initial clinical experience with two sutureless aortic bioprostheses: the Perceval S and the 3f Enable.
- To compare intraoperative data, postoperative outcomes, and echocardiographic results between the two prostheses.
Main Methods:
- A comparative study involving 97 patients receiving the Perceval S and 32 patients receiving the 3f Enable prosthesis.
- Data collection included intraoperative parameters, clinical outcomes, and echocardiographic assessments across two international cardiac surgery centers.
Main Results:
- Both prostheses were implanted using minimally invasive approaches in a significant proportion of patients.
- The Perceval S group exhibited shorter aortic cross-clamp times (36 ± 12.7 min vs. 66 ± 18 min) compared to the 3f Enable group.
- At follow-up, the Perceval S showed a lower incidence of moderate paravalvular leak (1 vs. 4) and a lower mean transvalvular gradient (9.1 ± 3.3 mm Hg vs. 11.2 ± 5.2 mm Hg).
Conclusions:
- Sutureless aortic bioprosthetic valve implantation is a feasible option, including via minimally invasive AVR.
- The Perceval S demonstrated advantages in reduced operative times and improved hemodynamic profiles over the 3f Enable.
- Both sutureless bioprostheses exhibit excellent hemodynamic performance, warranting further long-term investigation.
