The Toronto SPV bioprosthesis: One-year results in 100 patients

Background. We studied the long-term results of heart valve replacement with the Toronto SPV bioprosthesis. Methods. From March 1993 until July 1994 the Toronto stentless bioprosthesis was implanted in 100 selected patients with a mean age of 70.7 years. The predominant aortic valve lesion was stenosis in 94 and insufficiency in 6 cases. Eighty-eight patients received a valve 25 mm in diameter or larger. Additional coronary artery bypass grafting was performed in 37 cases. Hospital mortality was 4%. Seventy-four patients were seen at 6 months and 38 patients at 1 year follow-up. Results. Structural deterioration, thromboembolism or hemorrhage were not encountered. Nonstructural dysfunction lead to reoperation in 1 patient. Another patient presented with endocarditis at 1 year postoperatively. There were no other valve-related complications. Echocardiographic mean pressure gradients ranged from 7.7 to 11.1 mm Hg postoperatively. There was a significant decrease in pressure gradients at 6 months of follow-up. Minimal aortic valve incompetence was seen in 3 patients. Conclusions. The Toronto stentless bioprosthesis has superior hemodynamics and is an excellent alternative to conventional stented bioprostheses. Long-term evaluation has to prove whether this promising new valve can live up to its expectations.