{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:45:57Z","timestamp":1778201157804,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although the Perceval sutureless aortic valve bioprosthesis presents a feasible alternative to conventional aortic valve prostheses, the extent of its applicability with respect to technical considerations for a real-world patient collective is still under debate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred patients received the Perceval prosthesis [males: 59; age: 72.5 (7.3\u201379)\u2005years] between December 2015 and February 2023 [EuroSCORE II: 2.8 (1.7\u20135.4)] for an aortic valve replacement (AVR), with additional concomitant procedures, for underlying severe aortic valve stenosis [<jats:italic>n<\/jats:italic>\u2009=\u200993 (93)], endocarditis [<jats:italic>n<\/jats:italic>\u2009=\u20095 (5)], and redo AVR [<jats:italic>n<\/jats:italic>\u2009=\u20097 (7)] including a prior surgical AVR [<jats:italic>n\u2009<\/jats:italic>=<jats:italic>\u2009<\/jats:italic>4 (4)] and a failed transcatheter aortic valve implantation [<jats:italic>n\u2009<\/jats:italic>=<jats:italic>\u2009<\/jats:italic>3 (3)]. Surgery was conducted primarily by median sternotomy [<jats:italic>n\u2009<\/jats:italic>=<jats:italic>\u2009<\/jats:italic>71 (71)] and, alternatively, by the upper hemisternotomy approach [<jats:italic>n<\/jats:italic>\u2009=\u200929 (29)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a median follow-up time of 36.5 (16.5\u201353) months, eight patients (8%) underwent postoperative pacemaker implantation, with five (5%) due to high-grade atrioventricular block, while nine patients experienced a stroke (9%). The median values of maximum and mean gradients across all valve sizes were 22 (18\u201327.5)\u2005mmHg and 10 (13\u201318)\u2005mmHg, respectively. Two patients (2%) had moderate and one (1%) had severe paravalvular leakage, with the latter presenting the only case of underlying valve migration and induced redo AVR with valve explantation 2 days following initial surgery. Thirty-day mortality (and overall mortality) was 5% and 26%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The implantation of the Perceval bioprosthesis is feasible for a variety of indications, with excellent hemodynamic results and low complication rates in a real-world high-risk patient collective.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1417617","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T04:39:01Z","timestamp":1720759141000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Single-center real-world data and technical considerations from 100 consecutive patients treated with the Perceval aortic 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