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Ann Thorac Surg 2001;71:S302-S305
© 2001 The Society of Thoracic Surgeons

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Bioprosthetic valves and conduits: new developments

Clinical outcomes after aortic valve replacement with the Toronto stentless porcine valve

^a Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada

Address reprint requests to Dr Bernard S. Goldman, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Ave, H410, Toronto, ON, M4N 3M5, Canada
e-mail: bernard.goldman{at}swchsc.on.ca

Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.

Background. Hemodynamic benefits of the Toronto stentless porcine valve have been documented. Clinical well-being and freedom from major valve-related events have been less well defined.

Methods. A total of 447 patients were prospectively followed for up to 8 years (1,745.2 valve years total, 3.9 valve years/patient). The patient demographics included 66% men, mean age 65 years, New York Heart Association functional class III–IV 55%, concomitant coronary artery bypass grafting 41%.

Results. We found that 83.7% of patients were in New York Heart Association functional class I and 80.8% had 0 to 1+ aortic insufficiency. Mean gradient at 6 years (n = 75) was 4.4 mm Hg and mean effective orifice area (EOA) 2.4 cm². Late adverse event rates per patient per year were: embolism 1.0%, endocarditis 0.4%, thrombosis 0%, structural deterioration 0.2%, explant 0.3%, and valve-related death 0.6%. Freedom from valve-related death at 6 years was 95.8%; from cardiac death 96.3%. Freedom from endocarditis was 98.4%, from embolism 93.9%, from structural deterioration 97.4%, and freedom from explant 98.1%. For patients older than 60 years, freedom from structural deterioration was 100%.

Conclusions. These results confirm satisfactory clinical outcomes after aortic valve replacement with the Toronto stentless porcine valve, with a low incidence of valve-related adverse events as long as 96 months after valve replacement.

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