Technical aspects of implanting the St. Jude Toronto stentless porcine valve

Stentless xenograft aortic valves were designed ro provide superior hemodyn amic characteristics and durability in comparison with stented tissue valve s. The senior author (MJR) has implanted 46 St. Jude Toronto stentless porc ine valves-with excellent hemodynamic results and no aortic insufficiency-s ince this valve was released by the Food and Drug Administration in Novembe r 1997. Because the implantation technique is significantly different from that of implanting a stented valve, and because proper implantation is crit ical for proper valve function and avoidance of aortic insufficiency we dis cuss our technique in some detail.