Key result
In pigs, the stentless Solo valve had a larger cross-sectional area at the annulus (2.83 cm2) than the stented Mitroflow (2.24 cm2) and Toronto SPV (1.87 cm2) valves (P=0.003; P=0.01).
Why the study?
Do stentless bioprosthetic valves improve aortic root distensibility and cross-sectional area compared to stented valves in pigs?
Do stentless bioprosthetic valves improve aortic root distensibility and cross-sectional area compared to stented valves in pigs?
Absolute Event Rate: 2.83% vs 2.24%
p-value: p=0.003
In a porcine model, stentless bioprosthetic valves preserved aortic root distensibility at the annular level similarly to native valves, unlike stented valves.
Stentless valves yield larger annular area in pigs; leaves open translation to human aortic root dynamics or outcomes.
A flexible aortic root is essential for natural leaflet stress distribution. It is suggested that stentless bioprosthetic valves retain the flexibility of native valves. We investigated aortic root distensibility and cross-sectional area (CSA) in stentless (Solo, n=4; Toronto SPV, n=7), stented (Mitroflow, n=8) and in native valves (n=8) in pigs. Magnetic resonance imaging was performed to assess aortic root areas. At the annular level the Solo valve had a larger CSA (2.83+/-0.26 cm(2)) than both the Mitroflow (2.24+/-0.23 cm(2)) and Toronto SPV (1.87+/-0.59 cm(2)) (P=0.003; P=0.01). At the sino-tubular junction the Mitroflow valve had a significantly larger CSA (2.96+/-0.80 cm(2)) than the Toronto SPV (2.05+/-0.47 cm(2); P=0.02). At the annular level the percentage change in area between end-diastole and end-systole was lower for the Mitroflow than for all the other valves (P=0.006). No difference was found between native and stentless valves. In conclusion, the Solo valve had a larger CSA at the annulus than both the Mitroflow and the Toronto SPV. However, the stentless valves had a smaller CSA at the sino-tubular junction than the Mitroflow. We, furthermore, found that implantation of stentless heart valves preserves aortic root distensibility at the annular level in pigs.
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Funder et al. (2010) studied Bioprosthetic valve implantation (n=27). Stentless bioprosthetic valves (Solo, Toronto SPV) vs. Stented bioprosthetic valves (Mitroflow) and native valves was evaluated on Cross-sectional area (CSA) at the annular level (p=0.003). In pigs, the stentless Solo valve had a larger cross-sectional area at the annulus (2.83 cm2) than the stented Mitroflow (2.24 cm2) and Toronto SPV (1.87 cm2) valves (P=0.003; P=0.01).
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