The stentless porcine valve

Recognition of the long-term results of homografts has brought about a renewed interest in stentless valves. This has been matched by the introduction of several glutaraldehyde preserved porcine stentless prostheses. The early experience indicates that these valves are technically somewhat simpler to insert than homografts and are associated with satisfactory early and immediate-term results. In particular, they appear to offer an earlier and more complete resolution of left ventricular hypertrophy. Correct insertion of a stentless porcine valve needs meticulous attention to detail and awareness of the precise anatomical features of the aortic root, which is a complex structure. Although the myocardial ischemic and cardiopulmonary bypass times are longer for the more complex insertion of this prosthesis, our studies indicate that this has no serious disadvantage to the patient and is more than matched by an improved hemodynamic performance associated with more stable left ventricular function. The theoretical advantages of a stentless valve substitute in the aortic position seem clear. Further detailed prospective studies are needed to report on the long-term performance of this valve.