**8. Sutureless MIAVR**

Encouraging results have been reported with the three different suture less or rapid deployment bio prosthesis [31, 32]. Micelli et al. [33] reported 38 and 40% decrease in cross clamp and CPB time in RAMT group and 43 and 35% decrease in MS group. The operative mortality was 0.7% with a very low incidence of paravalvular leak (1.8%), a frequent complication of TAVI.

Santarpino et al. [34] reported similar improved results with suture less valves, suggesting that suture less MIAVR may become the first line treatment in high risk patients in the spectrum between TAVI and conventional AVR. Randomized controlled trials are required to confirm this.
