Perceval

The first surgical aortic valve replacement (AVR) was performed by Hufnagel in 1952 while in 1962; Magovern introduced the concept of sutureless AVR. The procedure was performed on a 43 year old woman with aortic regurgitation-leading to a cardiopulmonary bypass time of 28 minutes. The idea behind the concept was to shorten the procedure time. Both the Hufnagel and Magovern valves were actually sutureless valves (1). Surgical AVR improved survivability and quality of life in severe aortic stenosis. However almost one third of patients were not eligible for surgery because of comorbidities and higher risk. Medical therapy for those patientswas also suboptimal. Transcatheter aortic valve replacement (TAVR) was first introduced in 2002 for these high risk, inoperable patients. The field of surgical AVR made a rapid advance in the early 2000s with the introduction of the transcatheter valve therapy. Until that time surgical AVR was the only strategy for severe aortic stenosis. By 2016, TAVR produced real revolution in the management of severe aortic stenoses especially in high risk patients. This new therapy has been evaluated in major controlled clinical trials comparing surgical AVR (SAVR) versus TAVR. The interventional cardiologists started to push TAVI for all comers regardless of the risk profile.