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Related Experiment Video

Updated: Apr 17, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Challenge for perceval: aortic valve replacement with small sutureless valves--a multicenter study.

Emmanuel Villa1, Antonio Messina1, Francois Laborde2

  • 1Cardiac Surgery Unit, Fondazione Poliambulanza, Brescia, Italy.

The Annals of Thoracic Surgery
|February 10, 2015
PubMed
Summary

The smallest sutureless Perceval valves demonstrate safe and effective performance in patients undergoing aortic valve replacement (AVR). Prosthesis size did not impact patient outcomes or survival rates in this multicenter study.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Prosthetics

Background:

  • Controversy exists regarding the performance of small aortic prostheses (< 21 mm) after aortic valve replacement (AVR).
  • Small prostheses are linked to increased morbidity and mortality due to higher gradients.
  • Sutureless valve technology offers a potential solution, necessitating evaluation of the smallest models.

Purpose of the Study:

  • To assess the performance of the smallest Sorin-Perceval sutureless prosthesis compared to larger models.
  • To evaluate the safety, efficacy, and ease of insertion of small sutureless valves in patients with small aortic annuli.

Main Methods:

  • Retrospective review of 276 consecutive patients from 4 European centers undergoing AVR.
  • Comparison of outcomes between patients receiving the smallest Perceval valve (S group, n=47) and larger models (L group, n=229).
  • Analysis of preoperative characteristics, surgical data, and postoperative outcomes including gradients, indexed effective orifice area, and survival.

Main Results:

  • No significant differences in preoperative risk scores or surgical approach between groups.
  • Similar cardiopulmonary bypass and cross-clamp times for isolated AVR.
  • Nil hospital mortality in the small valve group versus 2.6% in the larger valve group (p=0.62).
  • No significant differences in peak-pressure-gradients or indexed effective orifice areas at discharge.
  • Comparable echocardiographic data and survival rates at a mean follow-up of 1.5 years.

Conclusions:

  • The smallest Perceval sutureless prosthesis is safe and effective for AVR in elderly patients with small annuli.
  • Sutureless valve technology facilitates insertion and provides satisfactory performance regardless of prosthesis size.
  • Prosthesis size did not influence patient outcomes, confirming the utility of small sutureless valves.