Stentless aortic bioprosthesis? The way forward: Early experience with the Edwards valve

Abstract

Tissue valve degeneration has been variably attributed to preservation and fixation methods. Additionally, a rigid valve ring might contribute to valve failure. The use of a nonstented porcine valve in the aortic position has clear hemodynantic advantages, and the lack of a stent may favorably influence long-term function. We have implanted stentless aortic valves (Prima valve) in 31 patients. There were 17 men. The mean age was 71.5 years (range, 50 to 83 years). After sculpturing of the sinuses the valve is positioned below the coronary arteries. Valve sizes ranged from 19 to 27 mm. There were no early or late deaths. Mean follow-up to date is 8.9 months (range, 4 weeks to 15 months). Early hemodynamic follow-up using Doppler echocardiography shows average peak systolic and mean gradients of 20.4 mm Hg and 8.6 mm Hg, respectively, at 4 weeks in 26 patients, with no significant change in 13 patients at 6 months. All patients are currently in New York Heart Association class I or II. Our early experience of stentless aortic valves shows them to be reliable with a satisfactory early hemodynamic profile. Their use in the elderly may conserve homografts for children and the young.