Sutureless and rapid deployment valves: implantation technique from A to Z-the Perceval valve

In the last two decades, sutureless (Perceval, LivaNova PLC, London, UK) and rapid deployment valves (RD) (Intuity, Edwards Lifesciences, Irvine, CA, USA) were introduced to the market as an innovative alternative to traditional valves for patients requiring an aortic valve replacement (AVR). These devices have been studied extensively and in use across the last fifteen years. They have proven to not only demonstrate comparable results with conventional sutured biological valves-particularly helpful in minimally invasive cardiac surgery-but also provide an almost curative treatment to patients with intermediate-to-high surgical risk, filling the gap between transcatheter aortic valve implantation (TAVI) and traditional AVR. However, both sutureless and RD valves require special steps for implantation, resulting in a learning curve. Specific training for all surgical team members is mandatory, as recommended by the manufacturers. The aim of this review article is therefore to provide cardiac surgeons with a thorough guide on the implantation technique for each of these two prosthetic devices, from A to Z. In this first article, we will start by focusing on Perceval.