Stentless aortic valve replacement with Freestyle or Toronto SPV: an early comparison

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Medical Devices

Background:

• Stentless aortic xenograft valves aim to improve upon conventional stented prostheses.
• Two novel aortic bioprostheses, Medtronic Freestyle and St. Jude Toronto SPV, were evaluated.
• Early clinical outcomes of these new valves were compared.

Purpose of the Study:

• To compare the early results of the Medtronic Freestyle and St. Jude Toronto SPV stentless aortic xenograft valves.
• To assess the performance and safety of these novel aortic bioprostheses.

Main Methods:

• Forty-four Medtronic Freestyle valves were implanted using a freestanding total root technique.
• Fourteen St. Jude Toronto SPV bioprostheses were implanted in a subcoronary position.
• Sixty-four percent of patients in both groups underwent concurrent procedures.

Main Results:

• No operative deaths or valve-related reoperations occurred in either group.
• Effective orifice areas were comparable: 1.83 +/- 0.51 cm² for Freestyle and 1.80 +/- 0.51 cm² for Toronto SPV.
• The Freestyle valve exhibited a significantly lower transvalvular gradient (8.03 +/- 4.09 mm Hg vs. 12.4 +/- 1.82 mm Hg) and less aortic regurgitation compared to the Toronto SPV.

Conclusions:

• Aortic valve replacement with Freestyle and Toronto SPV valves requires similar implantation times and results in comparable effective orifice areas.
• The Freestyle stentless aortic xenograft valve offers advantages of lower transvalvular gradient and reduced aortic insufficiency without increased morbidity or mortality.
• Both bioprostheses represent viable options for aortic valve replacement, with Freestyle showing superior hemodynamic performance in early follow-up.