Stentless Valve Replacement

There are many considerations in choosing the type of valve for aortic valve replacement, and each patient will ultimately need to discuss the type of valve with a cardiac surgeon. Your physician may choose to use a stentless valve for aortic valve replacement. Stentless valves are porcine valves that are unique in that there is no additional structure (stent) added to the valve.

Stentless Valve for Aortic Valve Replacement

One main advantage of stentless valves is that anticoagulants are not needed, which can carry increased risk of stroke and other medical complications. In addition, the stentless valve has superior hemodynamics. This means that the stentless valve more closely resembles the patients' own valve. In a stented valve, there is a ring that adds structure to the valve, but takes up space in the annulus. Stentless valves do not have this ring, and are therefore larger. Finally, stentless valves have the advantage of excellent long-term performance. There is a low percentage of replacement at 10 years post-surgery.

Stentless Valve in Aortic Valve Replacement Surgery

The aortic valve is located between the powerful left ventricle and the aorta, which connects the blood pumped from the heart to the rest of the body. (For more information, please see our overview on the aortic valve). The aortic valve is crucial in maintaining flow of blood from the heart to the rest of the body. Although the mitral valve can often be repaired, the aortic valve is usually replaced when there is disease because of the high pressure and volume through the aortic valve. To determine if there are options for aortic valve sparing techniques, please contact a cardiac surgeon at (949) 650-3350.

Aortic Valve Replacement Surgery

In aortic valve relpacement surgery, the patient is put to sleep with general anesthesia and an anesthesiologist monitors consciousness throughout the operation. Once the patient is asleep, the surgeon makes an incision down the middle of the chest and separate the breastbone. The patient is placed on the heart-lung machine to do the work of breathing and pumping oxygenated blood for the patient.

The surgeon will then access the heart and carefully remove the damaged valve. The diseased valve is discarded and the new stentless valve is inserted in its place. The surgeon will then use sutures to close the heart and sternum.

After surgery, the patient will be taken off the heart-lung machine and moved to the CVICU (Cardiovascular Intensive Care Unit) where specialized staff will closely monitor the patient.

Risks of Surgery

Open-heart surgery is considered a major surgical operation and as such is associated with the following risks: stroke, heart attack, bleeding, infection, nerve damage, breathing problems, drug reactions, blood reactions, arrhythmias and death. Your surgeon will discuss these and other risks with you before your operation.

Other Information on Stentless Valves for Aortic Valve Replacement

St. Jude Medical - Stentless Valve Information
NIH Article - Stentless Valve vs. Homograft for Aortic Replacement