Novel Treatment of a Degenerated Bioroot With the Use of the Sutureless Valve Technique

We describe 3 patients with severe aortic regurgitation after aortic root replacement using the Freestyle bioprosthesis (Medtronic, Minneapolis, MN). The indication in 2 patients was endocarditis. The third patient showed rupture of the right coronary cusp. To achieve fewer complications, lower operative risk, and reduce operative and cross-clamp times, implantation of a sutureless bioprosthesis in a valve-in-valve manner was performed. A Perceval bioprosthesis (Sorin Biomedica Cardio Srl, Sallugia, Italy) was used in 2 patients, and a 3F Enable bioprosthesis (Medtronic) was used in the other patient. No perioperative complications or in-hospital deaths were observed. We conclude that sutureless aortic valve prostheses offer a safe and feasible option for management of failed homografts.