Stentless aortic valve replacement with freestyle or Toronto SPV: An earlycomparison

Background. Stentless aortic xenograft valves have been developed to overco me the disadvantages of conventional stented prostheses. We have implanted two new aortic bioprostheses: the Medtronic Freestyle and the St. Jude Toro nto SPV. Early results are compared. Methods. Forty-four Freestyle valves were implanted using a freestanding to tal root technique. Fourteen sub-coronary Toronto SPV bioprostheses were im planted. Sixty-four percent of both groups (28 of 44 Freestyle and 9 of 14 Toronto SPV) underwent concurrent procedures. Results. Ischemic time was 117 +/- 21 minutes for Freestyle and 124 +/- 19 minutes for Toronto SPV. There were no operative deaths or valve-related re operations. Aortic valve area was 1.83 +/- 0.51 cm(2) for Freestyle and 1.8 0 +/- 0.51 cm(2) (p = 0.89) for Toronto SPV. Transvalvular gradient was 8.0 3 +/- 4.09 mm Hg for Freestyle and 12.4 +/- 1.82 mm Hg (p = 0.002) for the Toronto SPV. Aortic regurgitation was not experienced in any Freestyle pati ents, while Toronto SPV patients were graded as none to trace 79% (11 of 14 ), mild 14% (2 of 14), and moderate 7% (1 of 14). Conclusions. Aortic valve replacement with the Freestyle and Toronto SPV re quired equal time for implantation and had equal effective orifice areas. F reestyle had lower transvalvular gradient and less aortic insufficiency wit hout increasing morbidity or mortality. (Ann Thorac Surg 2000;70:48-52) (C) 2000 by The Society of Thoracic Surgeons.