Impact of Small Valve Size on Hemodynamics and Left Ventricular Mass Regression with the Toronto SPV^® Stentless Aortic Bioprosthesis
David S. Bach MD, Bernard Goldman MD, Edward Verrier MD, Michael Petracek MD, Jeremy Wood MD, Scott Goldman MD, Tirone David MD

The present study compared hemodynamic parameters and degree of left ventricular (LV) mass regression between valve sizes for the Toronto SPV^® valve, with special interest in measures of relief of LV outflow obstruction afforded by the smallest valves. The study group comprised 257 patients with complete echocardiography follow up through three years. Mean and peak gradients fell, and effective orifice area (EOA) increased early after surgery, with no differences observed between groups. Indexed EOA was >0.9 cm²/m² for all valve sizes at one year after surgery. There was statistically significant LV mass regression for all valve sizes, and no differences between valve sizes in the magnitude of absolute or percent change in LV mass index between baseline and three years. The Toronto SPV valve demonstrates excellent parameters of hemodynamic performance for all valve sizes. These data suggest that prosthesis-patient mismatch should be minimized with the use of stentless aortic bioprostheses.