Stentless valves for aortic valve replacement

In addition to the problem of durability, most tissue valves used in surgery to treat aortic valve stenosis are also limited because the leaflets of the valve are mounted on a fixed ring called a stent. While this stent is necessary for constructing the valve, it can also limit the flow of blood through the valve, particularly for people who require small valve sizes.

To correct this problem, researchers devised a type of porcine (pig) valve that did not use a stent. Instead, these stentless valves come still attached to a piece of the aorta (aortic root).

To preserve the valve and maintain the strength of the tissue, the valve is put through a chemical preservation process. A ring of polyester is placed around a portion of the valve to help support it.

Of the various replacement valve types, stentless tissue valves are most similar to the heart's natural valves. The elimination of the stent is intended to provide improved blood flow. Special treatments for the tissue are meant to make these stentless valves especially durable.

Researchers are currently studying these stentless valves to find out about their risks and how effective they are.

What is the advantage of a stentless valve?

The advantage of a stentless valve is largely in the wider valve opening that allows blood to flow more freely, as it does with a normal, healthy valve. The better blood flows across the stentless valve, the more the new valve will be able to relieve the pressure overload in the left ventricle.

How long do stentless valves last?

Stentless valves have not been in use long enough to know how well they will hold up after 10 to 15 years. Because durability is essential for a replacement valve, stentless valves will likely remain a future, or frontier, treatment until researchers are able to study their long-term durability.

Last Updated: November 4, 2009

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