Echocardiographic assessment of stentless aortic bioprosthetic valves

Stentless tissue aortic valves are gaining in popularity because of advantages in hemodynamics and durability compared with stented bioprostheses. The absence of a rigid sewing ring and struts makes these valves pliable, and distortion at implantation can result in valve dysfunction. Because the anatomy and implantation techniques of stentless tissue valves are unlike those of mechanical and stented tissue valves, their echocardiographic appearance is unique on both intraoperative and subsequent transthoracic and transesophageal echocardiography. This report describes the echocardiographic appearance of normally functioning stentless tissue heterograft aortic valves as an aid to their intraoperative and subsequent echocardiographic assessment.