OBJECTIVES: Aortic valve replacement (AVR) is the most common heart valve operation, accounting for a conspicuous part of all valve surgery performed in the elderly.  Prolonged aortic cross-clamping times are an independent risk factor for worse outcomes. Perceval S is a new aortic valve which is implanted without need for suturing and a collapsed profile, thus allowing a significant reduction of cross-clamping times. METHODS: A patient-level simulation model fully coded in WinBugs was updated and extended to predict lifetime effectiveness and  costs of concomitant AVR procedures associated with this new valve in France and UK, as compared to traditional valve implants, from the cost perspective of the third party payer. Two price scenarios were evaluated, one in which the sutureless valve is sold at the double, and one at the triple price of its comparator. Unit costs and health state-specific utilities were retrieved from official and literature sources. Future costs and outcomes are discounted at a yearly 3.5% rate. Uncertainty is evaluated through the incorporated probabilistic sensitivity analysis and deterministic threshold analyses.  RESULTS: The model predicts that on average the use of the Perceval S valve instead of traditional sutured valves would yield incremental 0.21 LYs (0.16 QALYs) per patient, with an associated saving of  about 5,100 € and 4,400 £ in France and UK, respectively, in the first scenario, and of 2,600 € and 1,900 £, in the second. Deterministic threshold analysis indicates that the sutureless valve would remain averagely dominant as long as its price does not exceed 4.1 and 3.8 times that of the traditional valve, in France and UK, respectively. CONCLUSIONS: The sutureless valve offers the opportunity to improve outcomes in concomitant AVR at a reduced cost to the third party payers.