Aortic valve replacement with the Toronto SPV bioprosthesis

Abstract

The Toronto SPV is a Dacron covered stentless porcine aortic prosthesis used for aortic valve replacement (AVR). We implanted this valve in 53 patients with a mean age of 58 years. The predominant valve lesion was aortic stenosis in 39 patients, insufficiency in 13 and a failed bioprosthesis in one. Six patients also had mitral valve disease and 18 had coronary artery disease. There was one operative death. Patients have been followed for four to 58 months, mean 27 months. There have been two late deaths but neither one was valve related. The actuarial survival at four years was 92% +/- 5%. Two patients required reoperation for reasons other than failure of the stentless aortic valve. There have been no thromboembolic complications. No patient had had infective endocarditis. Doppler echocardiographic assessment of the stentless valve revealed excellent effective valve areas and low transvalvular gradients. A few patients developed mild aortic insufficiency after implantation of the valve, but this problem has been practically eradicated by correct sizing of the prosthesis. AVR with the Toronto SPV provides excellent functional and hemodynamic results. This bioprosthesis seems to be associated with an extremely low rate of valve related complications. These findings justify its continued use, but further follow up is needed to determine its durability.