Reoperation in Two Patients with SJM Toronto SPV and Medtronic Freestyle Stentless Bioprosthetic Valves

(Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Tokyo, Japan, and Department of Cardiovascular Surgery, Senpo Tokyo Takanawa Hospital*, Tokyo, Japan)

Yuki Ichihara Akihiko Kawai* Satoshi Saito
Kenji Yamazaki
Stentless bioprosthetic valves have been implanted for treatment of aortic valve disease, especially in elderly patients;these valves have the advantage of durability and excellent hemodynamics compared with stented bioprosthetic valves. Although good long-term results in patients with stentless bioprosthetic valves have been reported recently, reoperation has been gradually increasing. We performed reoperation for the SJM Toronto SPV and Medtronic Freestyle valves in one patient each. The SJM Toronto SPV was used in a 30-year-old woman;however, 8 years later, the valve showed severe calcification and adhesions, and could not be completely removed(Case 1). The other reoperation case, wherein a 69-year-old man underwent aortic valve replacement with the Medtronic Freestyle 4 years previously, showed no adhesion around the implanted valve, which could be easily removed from the autologous aortic annulus. Consequently, the first patient required reimplantation of a small mechanical valve(SJM #19). In contrast, we were able to use a stentless bioprosthetic valve(Prima Plus #23)for the second patient. Further observations on stentless bioprosthetic valves are required.
  Jpn. J. Cardiovasc. Surg. 41:139-143(2012)

Keywords:bioprosthetic valve, stentless Toronto SPV, Freestyle valve, reoperation