Sutureless Aortic Valve Replacement with the Perceval Plus® Versus TAVI: A Propensity-Matched Analysis of Postoperative Outcomes, Hematological Dynamics, and Inflammatory Response

Perceval Plus and TAVI are increasingly used for severe aortic stenosis, both relying on a self-expanding nitinol stent design, yet evidence specific to Perceval Plus remains limited regarding postoperative clinical outcomes and hematological and inflammatory dynamics. We compared postoperative clinical outcomes and longitudinal platelet/CRP dynamics between Perceval Plus and TAVI in a retrospective single-center cohort, in which 26 propensity score-matched pairs were obtained (1:1 matching) from patients undergoing Su-AVR (Perceval Plus, n = 53) or TAVI (self-expanding Medtronic devices, n = 101). Mortality, echocardiographic outcomes, and rates of postoperative atrial fibrillation and conduction disturbances showed no statistically significant differences between groups, while TAVI was associated with shorter ICU and hospital stay and Su-AVR required higher FFP transfusion (p = 0.016). Platelet count declined in both groups, with a deeper nadir in Su-AVR (postoperative day 3: 66% decline) versus TAVI (day 4: 27% decline), with a significant group × time interaction (p = 0.013); CRP rose in both groups but more rapidly and to a greater magnitude in Su-AVR (time and group × time interaction, both p < 0.001). Su-AVR and TAVI showed no statistically significant differences in the clinical safety outcomes assessed but differed in postoperative hematological and inflammatory magnitude, likely reflecting multifactorial procedure- and device-related mechanisms, warranting confirmation in larger, prospective, multicenter studies.