Outcomes with Toronto stentless porcine aortic valve: the Australian experience

The purpose of this study is to describe the Australian experience with TSPV in the aortic position in 543 patients followed for up to 8 years. Prospectively collected data were reviewed. The average age was 73.5 years, with 74.4% older than 70 years. Eighty-five percent of valves were calcified and 79.5% stenotic. Most valves implanted (79.3%) were sizes 25, 27, or 29 mm. Concomitant coronary bypass was performed in 45.3% of patients. Total cumulative follow-up for the 543 patients was 2131 patient years. At 6 years, 82.1% and at 8 years, 76.3% were in New York Heart Association class I, 55% had no aortic insufficiency. The average mean systolic gradient for all valves at 6 years was 7.4 mmHg. The effective orifice area varied from 1.7 cm(2) (23-mm valve) to 1.96 cm(2) (29-mm valve). Actuarial survival at 8 years was 79.3%. Freedom from valve-related deaths was 93.2%. There was one instance of primary tissue valve failure during follow-up, with 93.3% freedom from explant. The early hemodynamic benefits of the TSPV are well maintained during more than 8 years of follow-up, without evident significant valvular dysfunction. Longer follow-up time is required to validate durability.