Conclusions

All patients with indication for AVR with a biological bioprosthesis could potentially benefit from a shorter and easily reproducible treatment. This seems to be especially beneficial in patients more sensitive to ischemia, technically difficult procedures, patients with a high risk of PPM, and patients who require faster recovery.
Our study further confirms the excellent clinical and hemodynamic performance and safety of the Perceval ® valve, a truly sutureless aortic prothesis, in a moderately large cohort of patients, even up to the 5-year follow-up. Consistent with current literature, the Perceval ® valve allowed reduced aortic cross-clamping, CPB and surgical times due to its easy and rapid implantation technique as well as low rates of mortality, complications, or dysfunctions early and up to 5 years, even in our cohort of mostly older patients with comorbidities. Additionally, it has been proven to facilitate the reproducibility and resurgence of minimally invasive approaches, reducing additional postoperative complications.