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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 113-118, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
TE David, C Pollick and J Bos
Twenty-nine patients were entered in a clinical trial on aortic valve
replacement with a stentless glutaraldehyde-fixed porcine aortic valve.
This bioprosthesis is secured to the aortic root by the same technique used
for aortic valve replacement with aortic valve homografts. The functional
results obtained from this operation have been most satisfactory. To assess
the hemodynamic benefit of eliminating the stent of a porcine aortic valve,
we matched 22 patients with a stentless porcine bioprosthesis for age, sex,
body surface area, valve lesion, and bioprosthesis size to 22 patients who
had aortic valve replacement with a Hancock II bioprosthesis. Mean and peak
systolic gradients across the aortic bioprosthesis and effective aortic
valve areas were obtained by Doppler studies. Gradients across the
stentless bioprosthesis were significantly lower than gradients across the
Hancock II valve for every bioprosthesis size. Effective aortic valve areas
of the stentless bioprosthesis were significantly larger than the valve
areas of the Hancock II valve. Our data demonstrate that the hemodynamic
characteristics of a glutaraldehyde-fixed porcine aortic bioprosthesis are
greatly improved when the aortic root is used as a stent for the valve.
This technique of implantation is expected to enhance the durability of the
bioprosthesis, because the aortic root may dampen the mechanical stress to
which the leaflets are subjected during the cardiac cycle.
ARTICLES
Aortic valve replacement with stentless porcine aortic bioprosthesis
Division of Cardiovascular Surgery, Toronto Western Hospital, Ontario, Canada.
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P. Bertolini, G. B. Luciani, B. Vecchi, P. Pugliese, and A. Mazzucco Aortic valve replacement with the biocor PSB stentless xenograft Ann. Thorac. Surg., August 1, 1998; 66(2): 425 - 430. [Abstract] [Full Text] [PDF]
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T. E. David, R. Puschmann, J. Ivanov, J. Bos, S. Armstrong, C. M. Feindel, and H. E. Scully Aortic valve replacement with stentless and stented porcine valves: a case-match study J. Thorac. Cardiovasc. Surg., August 1, 1998; 116(2): 236 - 240. [Abstract] [Full Text] [PDF]
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G. B. Luciani, P. Bertolini, B. Vecchi, and A. Mazzucco Midterm results after aortic valve replacement with freehand stentless xenografts: a comparison of three prostheses J. Thorac. Cardiovasc. Surg., June 1, 1998; 115(6): 1287 - 1291. [Abstract] [Full Text] [PDF]
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D. F. Del Rizzo, B. S. Goldman, G. T. Christakis, and T. E. David HEMODYNAMIC BENEFITS OF THE TORONTO STENTLESS VALVE J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1431 - 1446. [Abstract] [Full Text]
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C. M. G. Duran, B. Gometza, N. Kumar, R. Gallo, and R. Martin-Duran AORTIC VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 511 - 516. [Abstract] [Full Text]
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F. W. Mohr, T. Walther, M. Baryalei, V. Falk, R. Autschbach, A. Scheidt, and H. Dalichau The Toronto SPV Bioprosthesis: One-Year Results in 100 Patients Ann. Thorac. Surg., July 1, 1995; 60(1): 171 - 175. [Abstract] [Full Text]
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N. D. Kon, S. Westaby, N. Amarasena, R. Pillai, and A. R. Cordell Comparison of Implantation Techniques Using Freestyle Stentless Porcine Aortic Valve Ann. Thorac. Surg., April 1, 1995; 59(4): 857 - 862. [Abstract] [Full Text]
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T. E. David, C. M. Feindel, J. Bos, Z. Sun, H. E. Scully, and H. Rakowski Aortic valve replacement with a stentless porcine aortic valveA six-year experience J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1030 - 1036. [Abstract] [Full Text]
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