Comparison of Surgical Treatment Outcomes in Patients with Hemodynamically Significant Aortic Valve Stenosis Using the Perceval Sutureless Bioprosthesis versus a Conventional Biological Valve

Objectives: This prospective case-control study aimed to compare the outcomes of aortic valve replacement using a Perceval sutureless bioprosthesis versus a conventional stented bioprosthesis in patients with hemodynamically significant aortic stenosis. Methods: A total of 233 elective patients who underwent aortic valve replacement at the University Clinical Center of Serbia between July 2017 and March 2021 were included in this study. Based on predefined criteria, 74 patients 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%) and a mean age of approximately 72.6 years. Combined aortic valve replacement and coronary artery bypass grafting were performed in 19.3% of the patients. In the sutureless group, the most common valve size was 23–25 mm (41.8%). The mean aortic cross-clamp time was significantly shorter in the Perceval group (92.1 ± 29.3 min) than in the conventional group (104.5 ± 29.6 minutes, p < 0.05). Thirty-day mortality was comparable between the groups (5.9% vs. 6.3%). At 36 months, the survival rate was significantly higher in the Perceval group (88.3% vs. 76.8%, p = 0.048). Conclusions: Perceval sutureless bioprostheses appear to be a safe and effective option, particularly for elderly high-risk patients, although their long-term durability remains to be confirmed.