Toronto porcine stentless valve and the need for something more

Stentless valves were greeted as a great step forward for the replacement of diseased aortic valves, particularly aortic valve s ten osis i n t he e lde rly. In 19 88, Ti rone Da vid developed a stentless xenograft (Toronto Stentless Porcine bioprosthesis) aimed to improve hemodynamics, valve durabi lity, a nd pati ent survi val [1]. This stent less valve truly resembles a human aortic valve, with cusps, commissures, and aortic wall posts. The lack of a frame greatly improves functional performance by diminishing postoperative transvalvular gradient, thus favoring regression of left ventricular hypertrophy and enhancing cardiac electrical stability. Recent study has confirmed that low gradients and large effective orif ice area are mai ntained at nine years after implant ation