The risk of oversizing with sutureless bioprosthesis in small aortic annulus.

The Perceval S (Liva Nova PLC, London, United Kingdom)sutureless bioprosthesis is a self-expanding bovinepericardial valve. Because of a simple and fast implantationtechnique, this valve allows a short crossclamp time withexcellent hemodynamics and almost no paravalvularleak.1,2The supplied sizers determine the best-suitedprosthesis by measuring the aortic annulus after native valveresection.3We report the case of 4 patients in whomincomplete deployment led to severe dysfunction andexplantation of the Perceval S bioprosthesis [...]