Pericardial and porcine stentless aortic valves: Are they hemodynamically different?

Background. We sought to compare the early hemodynamic performance of peric ardial stentless aortic valves with that of well-established porcine stentl ess aortic prostheses. Methods. A total of 169 patients (97 men and 72 women, aged 73 +/- 6 years) undergoing aortic Valve replacement received either a pericardial (Pericar bon, Sorin Biomedica, Saluggia, Italy; n = 89) or a porcine (Freestyle, Med tronic, n = 80) stentless aortic valve. Aortic valve hemodynamics and root dynamism were assessed by Doppler echocardiography at discharge and 12 mont hs after implantation. Results. Clinical demographic data, valve size (24.0 +/- 1.9 vs 24.6 +/- 2. 3 mm), and body surface area (1.85 +/- 0.19 vs 1.80 +/- 0.19 m(2)) did not differ between porcine and pericardial valves (both p > 0.05). The 1-year p ostoperative mean valve pressure gradient (4.2 +/- 2.6 vs 3.7 +/- 2.6 mm Hg ), effective orifice area (2.2 +/- 0.8 vs 2.2 +/- 0.8 cm(2)) and left ventr icular ejection fraction (62 +/- 13 vs 63 +/- 13, %) also did not differ ta ll p > 0.05). However, at discharge, systolic increase in aortic sinus diam eter was significantly greater in pericardial valves than in porcine ones ( 7.7 +/- 5.7 vs 4.9% +/- 4.2%, p < 0.01). Furthermore, pericardial valves ha d a greater slope of effective orifice area-systolic aortic flow relationsh ip (0.89 +/- 0.07 vs 0.70 +/- 0.06, cm(2)/100 mL/s, p < 0.01). Conclusions. Nonprosthetic thin-walled pericardial valves appear to offer b etter aortic root dynamism and more efficient hemodynamics than those of po rcine valves immediately after implant. At 1-year follow-up, however, both types of stentless valves provide equally excellent hemodynamics. The clini cal choice between the two will depend on their long-term durability. (C) 2 001 by The Society of Thoracic Surgeons.