Multicenter randomised study which aims to compare sutureless Vs. standard bio- prostheses (1:1) among patients undergoing surgical aortic valve replacement in terms of:

• 6 -month hemodynamic performance.
• 6 month clinical outcomes including all cause mortality, stroke, myocardial infarction, valve reoperation and major/life threatening bleeding
• Cost effectiveness

This study is aimed to compare clinical and hemodynamic performance of conventional sutured stented bio-prostheses among patients undergoing a surgical aortic valve replacement. The prostheses are not pre specified to be provided by a specific manufacturer, so that any bio prosthesis but transcatheter and scentless aortic valves can be implanted.

The estimated sample size is 350 patients. They will be randomised 1:1 to any of the two arms of the study (standard Vs. sutureless prostheses). The randomisation will be stratified according to the need for a concomitant coronary artery bypass grafting procedure.

Six hospitals in Madrid (Spain) will take part in the study. The period of recruitment will start as soon as June 2019 and is supposed to finish by June 2020 or earlier.

The main outcomes of the study will be measured 6 months after the aortic valve implantation

Inclusion Criteria:

• Patients older than 18
• Pure aortic stenosis or combined aortic stenosis/regurgitation
• Aortic annulus >18 mm and < 27 mm

Exclusion Criteria:

• Pregnancy
• Willing to receive some other prosthesis
• Concomitant surgery of the ascending aorta or left ventricle outflow tract
• Endocarditis
• Emergency
• Some other concomitant procedure
• Participation in any other study
• Previous surgery