Improved postoperative outcomes with stentless aortic valve: a community hospital experience.

St. Luke’s Hospital is a 436 bed community teaching hospital in Bethlehem, Pennsylvania, USA, performing an average of 750 open heart surgeries yearly by four cardiothoracic surgeons. The type of prosthesis for aortic valve replacement (AVR) chosen is based on durability, safety of postoperative anticoagulation, ease of implantation, and postoperative haemodynamic performance. Surgeons at St Luke’s Hospital began using the Toronto SPV (St Jude Medical, St Paul, Minnesota, USA) in 1997. Within a short time it was observed that a larger size Toronto SPV valve could be inserted into a smaller aortic root than mechanical or stented bioprosthetic valve. In addition, there was a perceived notion that patients who received a Toronto SPV valve recovered better during the early postoperative period than did those who received a mechanical or stented bioprosthetic valve. This observation was consistent with previously published outcomes that showed improved early and late haemodynamics with the Toronto SPV valve. 2 Consequently, a change in valve selection from mechanical to bioprosthetic valves was observed, with the increased use of bioprosthetic valves being related to the increased use of the Toronto SPV. Hence, the purpose of this study was to determine if there was early postoperative improvement in patients who received a Toronto SPV valve.