Echocardiographic Evaluation of Aortic Valve Replacement for Small Aortic Annulus: Comparison Between Sutureless and Stented Valves

Background: Sutureless valves are gaining interest for aortic valve replacement in patients with small annuli; however, their effectiveness compared to traditional valves remains unclear. This study aimed to explore the clinical outcomes and hemodynamic performance of sutureless versus stented valves. Methods: In total, 190 patients underwent aortic valve replacement (AVR) at two hospitals from May 2019 to March 2022; 60 patients underwent AVR with Perceval S sutureless aortic valves S size (P group), and 130 underwent AVR with INSPIRIS RESILIA 19 mm (I-19 group) or 21 mm valves (I-21 group). We retrospectively reviewed and analyzed the patient characteristics and intra- and postoperative outcomes. Results: The mean cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) times were significantly shorter in the P group than in the I group. There were no significant differences in intensive care unit length of stay, hospitalization, and 30-day mortality. The echocardiographic evaluation showed no significant differences in prosthesis performances between the P group and I-19 group 4–7 days after surgery. However, the performance in the I-21 group significantly differed from that in the P group. At the 1 year follow-up, prosthesis performance in the P group was equivalent to that in the I-21 group. Conclusions: Surgical intervention with S size Perceval S sutureless valves is a safe and effective treatment for patients with a small aortic annulus and demonstrates superior intermediate-term hemodynamic performance.