Selection of Aortic valve replacment

I am a healthy 55 years old male in good physical condition; in 1984 I received American Edwards Laboratories aortic pig valve replacement model 2625 size 29.

After 16 years the valve is now leaking and will need to replace very soon with a new one, because of my good experience with pig valve my replacement valve preference is a stentless porcine valve like the Toronto SPV.

Can a stentless tissue valve be install as a replacement for existing tissue valve or do I need remain with standard pig valve or change to mechanical valve (St. Jude Bileaflet) because of some surgical reason.

Jack

[Cleveland Clinic, MD]

Dear Jack,
I know of no reason why you can't have the valve replaced with a stentless valve but you should double check with your surgeon before surgery to make sure.  I agree with you that the stentless procine would be a good choice for your situation.

[Jack Mor]

I have two additional questions:

1.How dose a surgeon make a selection of a valve maker, say Toronto SPV or Freestyle, is that based on training or is it the hospital preference?

2.Is it easier for the surgeon to do a second sternotomy after 16 years and is it more forgiving to the patient?

Jack