Primary Implantation Failure
Primary implantation failure was defined as the presence of an obvious malposition or instability after valve release before closing the aortotomy, or as a more-than-trivial paravalvular leak after the aorta was unclamped.
In case of implantation failure, the surgeon could (i) reposition the same valve after re-collapsing (off-label maneuver), possibly completed by SCAP, (ii) use a different size of Perceval-S prosthesis, or (iii) switch to a sutured bioprosthesis.