Clinical Experience of Aortic Valve Replacement Using the New Stentless Bioprosthesis
Background: The SOLO SMART valve is a bovine pericardial stentless bioprosthesis which shows superior hemodynamic performance compared to the stented valves. It is designed for supraannular and subcoronary implantation. We report our surgical experience and results in patients undergoing aortic valve replacement(AVR) with this new bioprosthesis.
Methods: Since June 2016, 19 patients with various types of aortic valve disease (mean age:72±7 years, 58% males) have undergone AVR with a SOLO SMART stentless bioprosthesis. Fourteen patients(74%)showed aortic stenosis( AS) and 9 patients(47%)had concomitant procedures;coronary bypass grafting (n=4), mitral valve surgery (n=3), total arch replacement (n=1), and pulmonary venous isolation( n=1). There was 1 patient with active infective valve endocarditis( IE) complicated with annular abscess and 1 patient was a redo AVR case. Surgical results of these patients were evaluated retrospectively. The hemodynamic performance was investigated with transthoracic echocardiography in pre and postoperative period.
Results: There was no operative death and 1 hospital death (postoperative subdural hematoma;Heyde syndrome). One patient showed a mild trans-prosthetic valve leak. No patient required reoperation. Although postoperative transient thrombocytopenia was noted, it had cured at the time of discharge. At the last echocardiographic evaluation, the peak and mean gradients in the patients undergoing AVR for AS were 17±7 and 9±5 mmHg, respectively. No prosthesis-patient mismatch (PPM) occurred in any patient.
Conclusions: AVR using a SOLO SMART stentless bioprosthesis was performed with acceptable morbidity and mortality. The SOLO SMART stentless bioprosthesis showed excellent hemodynamic performance and early results. Because of favorable effective orifice area, the valve is attractive for patients at risk for PPM. Furthermore, it is expected to contribute to more complex AVR with concomitant mitral valve surgery, active IE or redo situation.