• Antonio Miceli, Giuseppe Santarpino, Steffen Pfeiffer, Michele Murzi, Daniyar Gilmanov, Giovanni Concistré, Eugenio Quaini, Marco Solinas, Theodor Fischlein, and Mattia Glauber.
• Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy; Bristol Heart Institute, Klinikum Nürnberg, Nürnberg, Germany. Electronic address: antoniomiceli79@alice.it.
• J. Thorac. Cardiovasc. Surg.. 2014 Dec 1;148(6):2838-43.

ObjectiveThe aim of our study was to evaluate the early outcomes and 1-year survival of patients undergoing minimally invasive aortic valve replacement with the Perceval S sutureless valve for severe aortic stenosis.MethodsFrom March 2010 to March 2013, 281 high-risk patients underwent minimally invasive aortic valve replacement with the Perceval S sutureless valve through either right anterior minithoracotomy (n = 164) or upper ministernotomy (n = 117) at 2 cardiac centers.ResultsThe overall in-hospital mortality was 0.7% (2 patients). The overall median cardiopulmonary bypass and crossclamp time was 81 minutes (interquartile range, 68-98) and 48 minutes (interquartile range, 37-60), respectively. Postoperative stroke occurred in 5 patients (1.8%). The incidence of paravalvular leak greater than 1 of 4 and atrioventricular block requiring pacemaker implantation was 1.8% (5 patients) and 4.2% (12 patients), respectively. No migration occurred, and the mean postoperative gradient was 13 ± 4 mm Hg. At a median follow-up of 8 months (interquartile range, 4-14), the overall survival was 90%.ConclusionsMinimally invasive aortic valve replacement with the Perceval S sutureless valve in high-risk patients is a safe and reproducible procedure associated with excellent hemodynamic results, postoperative outcomes, and 1-year survival.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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