Comparison of Surgical Treatment Outcomes in Patients with Symptomatic Severe Aortic Valve Stenosis Using the Perceval Sutureless Bioprosthesis Versus a Conventional Biological Valve.

Objectives: This single-center retrospective comparative cohort study aimed to compare the outcomes of aortic valve replacement using a Perceval sutureless bioprosthesis versus a conventional stented bioprosthesis in patients with symptomatic severe aortic valve stenosis. Methods: A total of 233 consecutive elective patients undergoing aortic valve replacement (AVR) at the University Clinical Center of Serbia (July 2017-March 2021) were analyzed: 74 received a Perceval sutureless valve, and 159 received a conventional stented valve. Results: The baseline characteristics were similar between the groups, with most patients being male (54.1% vs. 56.6%), with a mean age of 72.6 years. Combined aortic valve replacement and coronary artery bypass grafting were performed in 19.3% of the patients. Mean aortic cross-clamp (ACC) time was significantly shorter in the Perceval group for combined procedures (104.5 ± 29.6 min, p < 0.05) but similar in isolated AVR, likely reflecting the early institutional learning curve. Thirty-day mortality was comparable (5.9% vs. 6.3%). Importantly, at 36 months, survival was higher in the Perceval group (88.3% vs. 76.8%, p = 0.048). Longer echocardiographic follow-up (up to 58 months) was available for the Perceval group. Conclusions: Perceval sutureless bioprostheses are a safe and effective option for elderly high-risk patients. The extended echocardiographic follow-up represents a novel contribution to the literature, although further data on long-term durability are needed.