THE OBRIEN-ANGELL STENTLESS PORCINE VALVE - EARLY RESULTS WITH 150 IMPLANTS

From August 1991 to June 1994, 150 patients underwent aortic valve rep lacement with the O'Brien-Angell stentless porcine xenograft (Brave Ca rdiovascular Model 300, Cryolife, Atlanta, GA). To establish trends we analyzed three consecutive groups of 50 patients. We found significan t differences in low postoperative gradients (mean less than or equal to 10 mm Hg): 24% in group 1, 42% in group 2, and 96% in group 3. Comp aring groups 1 and 3, gradients were significantly lower in all valve sizes. The difference is credited to better supraannular positioning o f the valve, which is the key to the learning curve. Trivial central r egurgitation was present in the three groups at 6%, 12%, and 0%, respe ctively Peripheral regurgitation was trivial in 6%, 8%, and 0%, and mi ld to moderate in 4%, 2% and 0%, respectively. Seventy-eight of 107 pa tients with an available follow-up exceeding 1 year had noninvasive co ntrols. Two early cases with moderate perivalvular leaks evolved to mo derately severe leaks. Two valves were explanted. The O'Brien-Angell s tentless valve is easy to handle and correct supraannular positioning provides excellent hemodynamic results.