What is the difference between 3F aortic and Sorin Solo stentless bioprosthetic heart valves?

Heart valve prosthesis, Aorta, Haemodynamics

We congratulate the authors for this valuable study [1]. We believe that the diameter of the sinotubular junction affects the coaptation of the aortic leaflets. However, this is not the only factor affecting coaptation. Annular diameter also contributes to the coaptation of the leaflets.

As shown in Fig. 1 of the original article, the circumferences of the annuli of Sorin Solo and 3F aortic are different although their diameters are identical. In our study [2], we demonstrated that stentless valves could expand their diameters as their reasons of haemodynamic superiority. In this study [1], 3F aortic valve could not alter its diameter while Sorin Solo valve could expand its diameter as much as the annular circumference permitted (by bringing the commissure and its point closest to the ventricle onto same plane). It is obvious in Fig. 4 that the tip of the annulus (the closest point of the annulus to the ventricle) in Sorin Solo valve moved towards the ventricle, seen as flattening.

If the pressure values within the ascending aorta were identical and the structure and length of the leaflets were same, the only parameters affecting the leaflet coaptation remained the annular diameters and hydrodynamics of the fluid – depending on diastolic pressure – within the ascending aorta.

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The authors of the original paper [1] were invited to comment on this Letter to the Editor but declined the offer.