Search

BACKGROUND Sutureless aortic valve prostheses have the potential of shortening surgical time, but if this results in improved clinical outcome remains to be determined. The aim of this study was to compare the outcome of patients undergoing conventional vs. minimally invasive AVR, with either a stented or sutureless bioprosthesis. METHODS From 2007 to 2015, 627 patients underwent elective isolated AVR and were divided into three groups: patients who underwent sutureless-AVR via J sternotomy (group A, N.=206) and patients who underwent stented-AVR via J sternotomy (group B, N.=247) or full-sternotomy (group C, N.=174). RESULTS Patients in group A were significantly older than groups B and C (77±5 vs. 74±7 and 70±8 years; P

Since the introduction of the sutureless Perceval® (Sorin Group, Saluggia, Italy) in Europe after CE mark in 2012, the "sutureless approach" is becoming more and more popular. Sutureless implantation in general is easy, fast and safe, but bears several potential pitfalls. This might result in inferior functional results affecting also clinical outcomes. In our center, more than 300 implant procedures have been performed up to date by mainly two senior surgeons. The technique is in the process of spreading to all surgeons performing aortic valve procedures. Proctored activities are completed at our and other institutions, and wetlab activities are conducted in collaboration with the manufacturer's research and development laboratory. This article was written to give a step-by-step advice for surgeons who want to start a sutureless program or even have made limited experience with this approach wanting to reconfirm their technique. The focus is kept on surgical aspects regarding indication, access, intra-operative exposure and implantation of the prosthesis.