Implantation technique of the Cryolife-O'Brien stentless xenograft aortic valve: the simple, rapid, and correct way to implant and the errors to avoid.

Implantation of the Cryolife-O'Brien Model 300 stentless composite porcine aortic xenograft valve for aortic valve replacement is different from that of other stentless valves. The valve is a symmetrical, composite, three noncoronary leaflet assembly, with a broad coaptive leaflet surface. Because the valve has only a small superior aortic wall cuff and no inferior cuff, a single continuous suture line of 3-0 polypropylene provides a rapid safe implantation in the supra-annular position. Consequently ideal recipients are elderly patients, who benefit from the short cardiopulmonary bypass time. This report describes the step-by-step technique of implantation and outlines the principles of maintaining symmetry during implantation. Errors to avoid are also discussed. This stentless valve has been used for aortic valve replacement in 267 elderly patients since 1992, with a 1.1% mortality, low morbidity, and excellent valve function.