ARYA Atherosclerosis Journal

How to avoid oversizing Perceval sutureless aortic valve: Technique

Document Type : Short Communication

Authors

Pouya Nezafati 1, 2, 3
Sumit Yadav 4, 5

1 Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW, Australia

2 Discipline of Biomedical Sciences and Molecular Biology, College of Medicine and Dentistry, Australian Institute of Tropical Medicine and Health, Centre for Molecular Therapeutics, James Cook University, Townsville, QLD, Australia

3 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Cardiothoracic Surgery, Mater Private Hospital, Townsville, QLD, Australia

5 College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia

https://doi.org/10.48305/arya.2025.43498.3031
Abstract
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.

Keywords

Perceval
Sutureless Aortic Valve
Technique
1. Cerillo AG, Amoretti F, Mariani M, Cigala E, Murzi M, Gasbarri T, et al. Increased Gradients After Aortic Valve Replacement With the Perceval Valve: The Role of Oversizing. Ann Thorac Surg. 2018 Jul;106(1):121-128. https://doi.org/10.1016/j.athoracsur.2018.01.041
2. Baert J, Astarci P, Noirhomme P, de Kerchove L. The risk of oversizing with sutureless bioprosthesis in small aortic annulus. J Thorac Cardiovasc Surg. 2017 Feb;153(2):270-272. https://doi.org/10.1016/j.jtcvs.2016.07.068
3. Salaun E, Mahjoub H, Girerd N, Dagenais F, Voisine P, Mohammadi S, et al. Rate, Timing, Correlates, and Outcomes of Hemodynamic Valve Deterioration After Bioprosthetic Surgical Aortic Valve Replacement. Circulation. 2018 Sep 4;138(10):971-985. https://doi.org/10.1161/CIRCULATIONAHA.118.035150
4. Barbeito MG, Francisco EC, Martinez PP, Garcia de Sierra CV, Gill CI, Laguillo CQ, et al. Surgical technique modifies the postoperative atrioventricular block rate in sutureless prostheses. J Thorac Dis. 2019 Jul;11(7):2945-2954. https://doi.org/10.21037/jtd.2019.07.31
5. Young Lee M, Chilakamarri Yeshwant S, Chava S, Lawrence Lustgarten D. Mechanisms of Heart Block after Transcatheter Aortic Valve Replacement - Cardiac Anatomy, Clinical Predictors and Mechanical Factors that Contribute to Permanent Pacemaker Implantation. Arrhythm Electrophysiol Rev. 2015 Aug;4(2):81-5. https://doi.org/10.15420/aer.2015.4.2.81
ARYA Atherosclerosis Journal
Volume 21, Issue 5
May and June 2025
Pages 1-3

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us