Symptomatic calcific stenosis of a Toronto stentless porcine valve

We describe the calcific structural failure of a Toronto stentless porcine valve (TSPV) which had been used to replace a calcified bicuspid aortic val ve in a 46-year-oId man. Against expectations, left ventricular hypertrophy persisted and the transvalvular pressure gradient rose to. 125 mmHg by 6 y ears with the patient becoming symptomatic and requiring redo surgery. On r emoval the TSPV showed atypical calcification of the leaflet hinges and wal l. To our knowledge this is the first case reported and it may have implica tions for long term durability and future surgery using this prosthesis. (C ) 2000 Elsevier Science B.V. All rights reserved.