What is the role of sutureless aortic valves in today's armamentarium?

INTRODUCTION: Sutureless and rapid-deployment aortic bioprostheses represent an emerging and promising technology for the treatment of aortic valve stenosis. Unlike traditional aortic bioprostheses, these devices are not hand-sewn, thus allowing a significant reduction in operative times, while facilitating minimally invasive surgery and complex cardiac interventions. Sutureless aortic valve replacement represents a less invasive treatment option and an excellent alternative to conventional aortic valve replacement in elderly and higher risk patients. Areas covered: This review summarizes the current literature on sutureless and rapid-deployment aortic bioprostheses, focusing on their hemodynamic and clinical performance. Moreover, we highlight clinical caveats associated with these devices and report the current recommendations for their use, as advocated by experts in the field. Expert commentary: Finally, we summarize our group's technical modification with regards to positioning of these bioprostheses and propose some technical aspects which could decrease post-procedural permanent pacemaker requirement.