ABSTRACT
Although no currently available device is an ideal substitute for the human aortic valve,1 a bioprosthesis which closely resembles the native valve offers certain theoretical advantages. While homograft aortic valves2-4 and stentless heterografts5-7 were successfully used to replace the human aortic valve more than 30 years ago, due to technical difficulties in implantation, and the development of commercially available stent-mounted porcine valves, interest in stentless valves declined while clinical experience with homografts remained limited to a few centres. However, the significant failure rates associated with stented xenografts,8 especially in younger patients,9 stimulated the development of an alternative to the conventional stented valve.
