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Objectives The aim of this study was to investigate the need for postoperative permanent pacemaker implantation (PPI) following sutureless and rapid-deployment aortic valve replacement (SuRD-AVR) in the context of a progress report from a large multicenter international registry (SURD-IR). Methods We retrospectively analyzed 4,166 patients who underwent SuRD-AVR between 2008 and 2019. The primary outcome was the need for PPI before discharge. The study population was analyzed separately according to the implanted prostheses (Su cohort and RD cohort). Each cohort was divided into two groups based on the operation date: an early group (“EG” = 2008–2016) and a late group (“LG” = 2017–2019). Results The rate of PPI decreased significantly in the Su cohort over time (EG = 10.8% vs LG = 6.3%, p Conclusions Our analysis showed a significant decrease in the PPI rate in patients who underwent Su-AVR over time. Patient selection as well as surgical improvements and a more accurate sizing could be correlated with this phenomenon. The RD cohort revealed no significant differences either in patient's characteristics or in PPI rate between the two time periods.

Background The objective of this study is to evaluate results of the initial experience with sutureless Perceval S for active prosthetic valve endocarditis (PVE). Materials and Methods From October 2012 to April 2014, five patients underwent surgery for aortic PVE with Perceval S bioprosthesis. Results There was one in-hospital death (20%). Echocardiography performed at discharge showed excellent hemodynamic performance of Perceval S bioprosthesis. Conclusion Aortic valve replacement with Perceval S sutureless valve in patients with PVE is a feasible and safe procedure, associated with low in-hospital mortality and good hemodynamic performance of the prosthesis.

Objectives: Sutureless aortic valve replacement (AVR) has been associated with excellent hemodynamic and clinical outcomes, but less is known on the outcomes of the patients operated on for complex surgery. We aimed to evaluate the early outcomes and 1-year follow-up of patients undergoing AVR with a self expandable sutureless valve and concomitant procedures. Methods: Two European centers participated in the study, with a total number of self expandable aortic valve prosthesis implants equal to 682 (time frame May 2010 - May 2014). Of them, 168 (mean age 76.7 ± 6.4 years, female gender 93 (55.4%)) have been operated on for concomitant procedures.. Minimally invasive approach was chosen for 30 (17.9%) patients (14 ministernotomies and 16 right anterior minithoracotomies). 12 (7.1%), 45 (26.8%), 96 (57.1%) and 15 (8.9%) patients received 21 mm, 23 mm, 25 mm and 27 mm size prostheses, respectively. Common implantation technique was implemented in all the patients; coronary artery bypass grafting (if any) and mitral valve repair/replacement (if any) were performed prior to aortotomy and aortic valve replacement. Results: Overall surgical mortality was 7 (4.2%). Cardiopulmonary bypass time and aortic cross-clamp time were 136.3 ± 48 (median and interquartile range: 92 (71–114 minute)) and 94.3 ± 33 (74 (52–98)) min, respectively. Median assisted ventilation time was 10 (range 3–380) h. Revision for bleeding was necessary in 11 (6.5%) patients. 2 (1.2%) patients developed permanent neurological deficit following stroke. In 3 (1.8%) patients transient ischemic attack was observed. In 5 (3.0%) patients acute renal failure developed postoperatively. Permanent pacemaker implant due to advanced atrioventricular block was required in 16 (9.5%). 6/161 (3.7%) patients died during follow-up (mean duration 14 ± 11 months). Mean transprosthetic gradient averaged 13.6 ± 5.4 mm Hg. Conclusion: Good early outcomes, comparable to those of tissue valve prostheses, can be achieved in patients, undergoing sutureless AVR and associated procedures. Shortening the operative times, the self expandable sutureless prosthesis amplifies the armamentarium of aortic valve prostheses and represents a useful tool for associated and complex procedures.

Sutureless aortic bioprosthesis implantation is an alternative technique in high-risk patients undergoing aortic valve replacement with a possible reduction in the extracorporeal circuit time and reliable haemodynamic features. A 3F Enable (ATS Medical—Medtronic, Inc., Minneapolis, MN, USA) has shown very good results. We report the first upward displacement of 3F Enable three months post implantation.