Key result
Balloon-expandable valves successfully treat degenerated Perceval-in-Freestyle bioprostheses via surgical or transcatheter approaches.
Why the study?
Degenerated sutureless-in-root prostheses present a surgical challenge and require effective management strategies.
Case Report (n=2)
Balloon-expandable devices offer a promising option for treating degenerated sutureless-in-root prostheses, with the choice between surgical and transcatheter approaches individualized.
Balloon-expandable valves may be considered for degenerated Perceval-in-Freestyle bioprostheses; leaves open need for prospective durability data.
BACKGROUND: The availability of sutureless prostheses has provided another tool for the treatment of degenerated aortic bioprostheses, mostly those used for aortic root replacement, such as stentless porcine or homograft. However, also sutureless-in-root prosthesis can undergo degeneration, presenting a further surgical challenge. CASE SUMMARY: We present 2 patients facing a degenerated M size Perceval prosthesis, previously implanted in a degenerated Freestyle valve. Both patients received a ballon-expandable valve. One, the younger patient, underwent open-heart surgery for sutureless explantation and then implantation of a new device. The other underwent transcatheter valve-in-valve procedure. DISCUSSION: The treatment of a degenerated sutureless-in-root necessitates re-intervention, with the balloon-expandable devices emerging as a highly promising option also in open-heart setting. TAKE-HOME MESSAGES: Degeneration of Perceval-in-Freestyle bioprostheses can be effectively managed. The choice between surgical and transcatheter implantation should be individualized, considering patient characteristics and anatomical suitability.
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D’Alonzo et al. (2026) conducted a case report in Degenerated sutureless-in-root prosthesis (n=2). Balloon-expandable valve implantation (surgical or transcatheter) was evaluated on Successful management/re-intervention.
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