STENTLESS AORTIC BIOPROSTHESIS - THE WAY FORWARD - EARLY EXPERIENCE WITH THE EDWARDS VALVE

Tissue valve degeneration has been variably attributed to preservation and fixation methods. Additionally, a rigid valve ring might contribu te to valve failure. The use of a nonstented porcine valve in the aort ic position has clear hemodynamic advantages, and the lack of a stent may favorably influence long-term function. We have implanted stentles s aortic valves (Prima valve) in 31 patients. There were 17 men. The m ean age was 71.5 years (range, 50 to 83 years). After sculpturing of t he sinuses the valve is positioned below the coronary arteries. Valve sizes ranged from 19 to 27 mm. There were no early or late deaths. Mea n follow-up to date is 8.9 months (range, 4 weeks to 15 months). Early hemodynamic follow-up using Doppler echocardiography shows average pe ak systolic and mean gradients of 20.4 mm Hg and 8.6 mm Hg, respective ly, at 4 weeks in 26 patients, with no significant change in 13 patien ts at 6 months. All patients are currently in New York Heart Associati on class I or II. Our early experience of stentless aortic valves show s them to be reliable with a satisfactory early hemodynamic profile. T heir use in the elderly may conserve homografts for children and the y oung.