The value of the stentless biovalve prosthesis *1An experimental study

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Abstract
Clinical use of the stentless bioprosthesis has not yet been acceptedworld-wide. Experimental studies are scarce. In a study in growing pigs, 23aortic valve replacements were performed (7 stented bioprostheses (STB), 10stentless bioprostheses (SLB) and 6 cryopreserved homografts (CAH)). Valveswere studied macroscopically and microscopically after explantation. Fiveanimals died between 1.5 and 4 months after implantation. Two STBs showedextreme calcific degeneration. A third STB animal died suddenly: this STBshowed only minimal leaflet calcification. One SLB was stenosed with alarge fibrin deposit in one cusp, a second SLB showed slight cuspcalcification and three were paracommissural tears in one cusp. In allother animals the valves were explanted after 5 to 6.5 months. All STBsshowed severe calcific degeneration. Five SLBs showed mild calcificdegeneration, while three others were unaltered after 6 months. All CAHswere free of calcific degeneration, three were perfect, two had a tear in acommisure and another was prolapsed with a fibrin degeneration. The speedand extent of valve degeneration were less than in the STB group. Thestentless design is an important contribution which may result in a higherdurability of bioprosthetic valves.

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