How to avoid oversizing Perceval sutureless aortic valve: Technique

Aortic valve replacement surgery technique has been revolutionised with the introduction of sutureless valves. Perceval sutureless aortic valve (PSV) is one of the most widely used examples. However, oversizing the PSV has been reported to be an issue. After a case of PSV stent recoil in our institution, a new technique was developed, where only the white obturator is used to size the valve. Recently, this technique was also mentioned by different authors. With this technique, we achieved low rates of paravalvular leaks and pacemaker implantation, with good transvalvular gradients. Therefore, we recommend this technique over the manufacturer's instructions.