EARLY EXPERIENCE WITH THE TORONTO STENTLESS PORCINE VALVE

Stentless porcine valves in the aortic position offer many theoretic a dvantages, but their clinical performance has not been adequately defi ned. We evaluated the clinical and echocardiographic results of 103 pa tients who had aortic valve replacement with the Toronto stentless por cine valve over a 2-year period. There were 67 men with a mean age of 68 years. The predominant native valve lesion was aortic stenosis (64% ), and 4 patients had prosthetic valve dysfunction. Forty-two patients had concomitant procedures. The 30-day mortality rate was 3.3% (n = 2 ) for isolated valve replacement and 5,8% (n = 6) for the series. The sole determinant of early death was poor left ventricular function. Th ere were three late deaths due to nonvalve-related complications over a median follow-up of 11.87 months. In addition, prosthetic valve endo carditis developed in 1 patient, necessitating a homograft valve repla cement at 6 weeks. Doppler echocardiography performed at 3 to 6 months showed low peak and mean transvalvular gradients, with no substantial change at 1 year. None of the patients showed signs of clinically sig nificant aortic regurgitation, although echocardiography demonstrated trivial or mild regurgitation in 12 patients at discharge or early fol low-up, which was less marked or absent at 1 year. We conclude that th e Toronto stentless porcine valve appears to offer promising early res ults.