The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology

Aortic stenosis affects more than 9 million people worldwide and is commonly treated with surgical aortic valve replacement (SAVR), which is known for producing excellent long-term outcomes. Recent advancements in transcatheter aortic valve replacement (TAVR) have shown noninferior or improved outcomes compared to SAVR across various risk levels. Despite TAVR's growth, innovations in surgical valves, such as sutureless aortic valves (SURD), are maintaining SAVR's relevance. The Perceval S valve, a sutureless option, has shown promising early and midterm results. It reduces cardiopulmonary bypass and aortic cross-clamp times, which are linked to lower morbidity and mortality. This review highlights the design, deployment, and clinical outcomes of the Perceval S valve. While it offers benefits similar to TAVR, it presents unique advantages for certain patients, including those requiring minimally invasive SAVR (such as robotic, mini thoracotomy, or mini sternotomy approach), those with small aortic annuli, patients undergoing concomitant procedures aimed at shortening cardiopulmonary bypass times, and redo scenarios. However, it presents unique risks as well, including an increased risk of postoperative need for permanent pacemaker implantation. Future research is needed to refine techniques and further evaluate long-term outcomes.