The extended Biocor stentless aortic bioprosthesis. Early clinical experience.

In the "Extended" Biocor stentless aortic bioprosthesis, supra- and subvalvular extensions to a bovine pericardium ring carry three porcine leaflets. The extensions cover the "non-coronary" sinus of the prosthesis and allow optional enlargement of the aortic root down towards the mitral valve as well as upwards into the aortotomy. Seventy-one patients with this stentless valve (62 with predominantly aortic stenosis, 28 with concomitant CABG) are being prospectively studied. This paper reports follow-up one year after insertion. The upper and lower pericardial extensions were used in 61 and 11 patients, respectively. The average prosthetic valve size was 23.2 +/- 1.6 mm. Early mortality was 7% (5/71); late mortality (4/66, 5%/patient year) was not valve-related. Symptoms of thromboembolism (new neurological defects) occurred in four patients. There was no valve failure or late endocarditis. One year postoperatively the transvalvular mean pressure difference for all valves was 7.9 (3.1-18.4) mmHg. None of the patients had haemodynamically significant aortic regurgitation at follow-up; nine had trivial regurgitation. The "Extended" Biocor stentless bioprosthesis thus has a favourable haemodynamic profile and can be advantageous in elderly patients with narrow aortic roots, and often with thin and/or calcified aortic walls.