Clinical Outcomes of Minimally Invasive Aortic Valve Replacement Using Sutureless Perceval Versus St. Jude Bioprosthesis

Background: To compare the clinical outcomes between isolated aortic valve replacement (AVR) using a conventional stented bioprosthetic valve (St. Jude, Epic™ Valve Porcine) and a sutureless bioprosthetic valve (Perceval). Methods: This single-center retrospective study evaluated 160 patients who underwent isolated surgical minimally invasive AVR between January 2020 and December 2024. Demographic, intraoperative, and postoperative data, as well as echocardiographic findings, were analyzed and compared. Results: Patients were divided into two groups: Perceval (n = 73) and St. Jude (n = 87). Patients in the Perceval group were older and had higher EuroSCORE 2 scores. The Perceval group showed significantly shorter cardiopulmonary bypass and aortic cross-clamp times (53.45 ± 24.18 vs. 68.02 ± 21.05 min; p < 0.001; and 40 ± 20.11 vs. 53.24 ± 17.34 min; p < 0.001). The intensive care unit (ICU) stay, intubation time, and hospital discharge time were significantly shorter in the Perceval group (p < 0.05). The requirement for inotropic support was also lower (2.8% vs. 24.1%, p < 0.001). At the 30-day follow-up, the perceval group had significantly lower mean and maximum transvalvular gradients. Complication rates were low in both groups, with one case of permanent pacemaker implantation and two reinterventions in the Perceval group. Conclusion: Sutureless AVR with a Perceval valve is a safe and effective alternative to conventional stented bioprostheses, particularly in elderly patients. It offers shorter operative times and improves early postoperative recovery without compromising the clinical or hemodynamic outcomes.