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D’Abramo et al. Vessel Plus 2019;3:4 Vessel Plus
DOI: 10.20517/2574-1209.2018.41

Review Open Access

Bridging aortic valve surgery to 21st century: what
can a surgeon do?

Mizar D’Abramo , Luisa Ferrante , Manuel Guerrera , Wael Saade , Ernesto Greco , Fabio Miraldi ,
1
1
3
2
1
1
Antonino Marullo , Mariangela Peruzzi , Antonio Barretta , Piero Proietti , Giuseppe Biondi-Zoccai ,
5
4
4
4,6
5
Sebastiano Sciarretta , Giacomo Frati , Alessandra Iaccarino 7,8
4,6
4,6
1 Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological, and Geriatric Sciences, Sapienza University of
Rome, Rome 00100, Italy.
2 Division of Cardiac Surgery, San Giovanni Battista Hopital “Molinette”, University of Torino, Turin 10126, Italy.
3 Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università
Cattolica del Sacro Cuore, Rome 00100, Itay
4 Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina 04100, Italy.
5 DAI Cardio Toraco Vascolare, Chirurgia e Trapianti D’Organo, Policlinico Umberto I, Sapienza University of Rome, Rome 00100, Italy
6 IRCCS Neuromed, Pozzilli 86077, Italy.
7 Department of General and Specialistic Surgery “Paride Stefanini”, Sapienza University of Rome, Rome 00100, Italy.
8 Department of Cardiac Surgery, Humanitas Clinical and Research Hospital, Rozzano 20089, Italy.
Correspondence to: Dr. Alessandra Iaccarino, Department of General and Specialistic Surgery “Paride Stefanini”, Sapienza
University of Rome, Rome 00100, Italy. E-mail: dr.alessandra.iaccarino@gmail.com
How to cite this article: D’Abramo M, Ferrante L, Guerrera M, Saade W, Greco E, Miraldi F, Marullo A, Peruzzi M, Barretta A,
Proietti P, Biondi-Zoccai G, Sciarretta S, Frati G, Iaccarino A. Bridging aortic valve surgery to 21st century: what can a surgeon do?
Vessel Plus 2019;3:4. http://dx.doi.org/10.20517/2574-1209.2018.41
Received: 1 Jun 2018 First Decision: 7 Sep 2018 Revised: 12 Nov 2018 Accepted: 4 Jan 2019 Published: 24 Feb 2019
Science Editor: Cristiano Spadaccio Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Aortic valve stenosis is the most clinically relevant valvular heart disease in the elderlies. Surgical aortic valve
replacement (SAVR) represented, for decades, the standard of care for the treatment of severe aortic stenosis. Although
SAVR still represents a valid option in this clinical scenario, transcatheter aortic valve implantation proved to be superior
to medical therapy and comparable to SAVR in several randomized trials in patients at high or intermediate operative
risk. At the same time, the growing aging population carrying on greater morbidities and high risk profiles has led to
the development of minimally invasive technologies, as rapid deployment aortic valve replacement or Sutureless, to
minimize surgical impact on patients. The Heart Team is nowadays tasked to determine the best option tailored for each
patient considering patient-related factors and mastering all the surgical options in terms of both different techniques
and types of available valves. Nevertheless, some open issues need to be already answered as: which has the longest
durability, which the lower complication rate and the lower overall mortality. The aim of this review is to briefly resume

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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