THE TORONTO SPV BIOPROSTHESIS - ONE-YEAR RESULTS IN 100 PATIENTS

Background. We studied the long-term results of heart valve replacemen t with the Toronto SPV bioprosthesis. Methods. From March 1993 until J uly 1994 the Toronto stentless bioprosthesis was implanted in 100 sele cted patients with a mean age of 70.7 years. The predominant aortic va lve lesion was stenosis in 94 and insufficiency in 6 cases. Eighty-eig ht patients received a valve 25 mm in diameter or larger. Additional c oronary artery bypass grafting was performed in 37 cases. Hospital mor tality was 4%. Seventy-four patients were seen at 6 months and 38 pati ents at 1 year follow-up. Results. Structural deterioration, thromboem bolism or hemorrhage were not encountered. Nonstructural dysfunction l ead to reoperation in 1 patient. Another patient presented with endoca rditis at 1 year postoperatively. There were no other valve-related co mplications. Echocardiographic mean pressure gradients ranged from 7.7 to 11.1 mm Hg postoperatively. There was a significant decrease in pr essure gradients at 6 months of follow-up. Minimal aortic valve incomp etence was seen in 3 patients. Conclusions. The Toronto stentless biop rosthesis has superior hemodynamics and is an excellent alternative to conventional stented bioprostheses. Long-term evaluation has to prove whether this promising new valve can live up to its expectations.