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\begin{document}

\title{USE OF SUTURELESS AND RAPID DEPLOYMENT PROSTHESES IN CHALLENGING
REOPERATIONS Review of the current evidence}



\author[1]{Igor Vendramin}%
\author[1]{Daniela Piani}%
\author[1]{Matteo Meneguzzi}%
\author[1]{Giovanni Benedetti}%
\author[1]{Daniele Muser}%
\author[1]{Uberto Bortolotti}%
\author[1]{Ugolino Livi}%
\affil[1]{University Hospital of Udine}%


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  \date{June 11, 2024}


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\begin{abstract}
Background and aim of the study: Sutureless and rapid-deployment
bioprostheses have been introduced as alternative to traditional
prosthetic valves to reduce cardiopulmonary and aortic cross-clamp times
during aortic valve replacement.These devices have been employed also in
extremely demanding surgical settings as underlined in the present
review. Methods: A search on PubMed and Medline databases aimed to
identify, from the English literature, the reported cases where both
sutureless and rapid- deployment prostheses were employed in challenging
surgical situations, usually complex reoperations sometimes even
performed as a bail out procedures. Results: We have identified 25
patients in whom a sutureless or a rapid-deployment prosthesis were used
in complex redo procedures. In 17 patients a failing stentless
bioprosthesis was replaced with a sutureless (n=14) or a rapid
deployment valve (n=3). Bioprostheses implanted at first operation were
mainly Freestyle (n=11) or Prima Plus (n=3) aortic roots, while Perceval
(n=13) and Intuity (n=3) were those most frequently employed at
reoperation. A failing homograft was replaced in 6 patients using a
Perceval (n=5) or an Intuity (n=1) bioprosthesis while a Perceval was
used to replace the aortic valve in 2 patients to treat failure of a
valve-sparing procedure. All patients survived reoperation and are
reported alive 3 months to 4 years postoperatively. Conclusions:
Sutureless and rapid-deployment bioprostheses have proved effective in
replacing degenerated stentless bioprostheses and homografts in
challenging redo procedures. In these setting, they should be considered
as a valid alternative not only to traditional prostheses but also in
selected cases to transcatheter valve-in-valve solutions.%
\end{abstract}%



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