Minimally invasive aortic valve replacement with sutureless valves

Purpose: Sutureless aortic valve replacement (SU-AVR) has emerged as an innovative alternative for treatment of aortic stenosis. This technology aims to reduce cardiopulmonary bypass (CPB) and cross-clamp times and thereby facilitate minimally invasive approaches. The present report is a mini-review of the current literature about results of minimally invasive SU-AVR. Methods: Electronic searches were performed including relevant studies about minimally invasive aortic valve replacement and sutureless valves. Data were analyzed and discussed. Results: Sutureless prostheses have resulted in shortened CPB and cross-clamp times in multiple studies and they have proven their suitability for different minimally invasive approaches. With the introduction of sutureless valves, the reported operative mortality of minimally invasive aortic valve replacement patients has decreased in last years. Compared to transcatheter aortic valve implantation (TAVI), SU-AVR has been associated with a trend of better early outcomes, including a reduced risk of paravalvular leakages, pacemaker implantation, and stroke. Conclusions: The combination of minimally invasive AVR and sutureless technology has been associated with excellent results; therefore, SU-AVR might be considered the real “alternative” to TAVI procedure for high-risk patients.