Aortic Root Enlargement or Sutureless Valve Implantation?


  • Nikolaos G. Baikoussis Evangelismos General Hospital of Athens, Athens
  • Panagiotis Dedeilias Evangelismos General Hospital of Athens, Athens
  • Michalis Argiriou Evangelismos General Hospital of Athens, Athens



perceval aortic valve, sutureless valves, small aortic root, patient-prosthesis mishmach, aortic root enlargement


Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM) post aortic valve replacement (AVR) is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR) and the transcatheter valve implantation (TAVI).


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Dumani S, Likaj E, Dibra L, Llazo S, Refatllari A. Aortic Annular Enlargement during Aortic Valve Replacement. Open Access Maced J Med Sci. 2016 Sep 15;4(3):455-457. https:/ PMid:27703574 PMCid:PMC5042634

Manouguian S, Seybold-Epting W. Patch enlargement of the aortic valve ring by extending the aortic incision to the anterior mitral leaflet. J Thorac Cardiovasc Surg. 1979;78:402—12. PMid:470420

Apostolakis E, Baikoussis NG, Papakonstantinou NA, Goudevenos J. Patient-prosthesis mismatch and strategies to prevent it during aortic valve replacement. Hellenic J Cardiol. 2011 Jan-Feb;52(1):41-51. PMid:21292606

Dedeilias P, Baikoussis NG, Prappa E, Asvestas D, Argiriou M, Charitos C. Aortic valve replacement in elderly with small aortic root and low body surface area; the Perceval S valve and its impact in effective orifice area. J Cardiothorac Surg. 2016 Apr 11;11(1):54. https:/ PMid:27066903 PMCid:PMC4827171

Baikoussis NG, Argiriou M, Argiriou O, Dedeilias P. Perceval S aortic valve implantation in an achondroplastic Dwarf. Ann Card Anaesth. 2016 Jan-Mar;19(1):166-8. https:/ PMid:26750695 PMCid:PMC4900406



How to Cite

Baikoussis NG, Dedeilias P, Argiriou M. Aortic Root Enlargement or Sutureless Valve Implantation?. Open Access Maced J Med Sci [Internet]. 2016 Nov. 16 [cited 2022 Jul. 6];4(4):742-3. Available from:



Letter to the Editor