Snugger method - The Oldenburg modification of perceval implantation technique.

We present a modified implantation technique of the Perceval® sutureless aortic valve (LivaNova, London, United Kingdom) that involves the usage of snuggers for the guiding sutures during valve deployment. Both limbs of each guiding suture are pulled through an elastic tube, which is fixed with a Pean clamp, which tightens the sutures and fixes the prosthesis to the aortic annulus during valve deployment. This method proved safe and useful in over 120 cases. Valve implantation was facilitated and the need for manipulation by the assistant or the nurse was eliminated.