Sutureless Aortic Valve Replacement

Abstract

Sutureless aortic valve replacement is an alternative to traditional open AVR. Sutureless implantable bioprostheses are mounted on self expandable nitinol frames which are implanted following resection of the diseased tissue. Sutureless valves provide the possibility of AVR with shortened CPB and cross-clamp times, the sternotomy may be partial, eliminate the need for many sutures as the valve is maintained in situ by the outward radial force of the frame , thereby facilitating minimally invasive approaches as well as concomitant cardiac surgery for high-risk patients. Currently, there are three main types of sutureless aortic prostheses which are available on the market, including the 3F Enable (Medtronic, Minneapolis, USA), Perceval S (Sorin, Saluggia, Italy) and Intuity (Edwards Lifesciences, Irvine, USA) sutureless valves. The potential benefits of sutureless aortic valve replacement are thatthe diseased valve is removed, combined pathologies of the aortic valve and the coronary arteries can be treated, the procedure may be quicker because the valve does not need to be sewn in, reducing cardiopulmonary and aortic cross-clamp times, facilitate the advantages of the minimally invasive approach with decreased hospitalization, reduction in sternal wound complications, reduced surgical trauma and improved cosmesis.current results suggest that SU-AVR may be associated with excellent hemodynamic outcomes, with very low transvalvular gradients and reduced risk of patient- prosthesis mismatch.