Bethesda resident Stephen Miller's aortic stenosis was starting to interfere with his life.

"He had shortness of breath, and he noticed that it was hard for him to do things that he used to do without thinking about it,” says cardiothoracic surgeon Reed Quinn, who practices at Suburban Hospital.

On Nov. 1, 2023, Quinn replaced Miller's faulty aortic valve with a valve implant.

The device he used was implanted without sutures. It consists of a bovine valve, fitted with a nickel titanium alloy stent that expands to hold it in position.

The valve was installed through a small incision in Miller's sternum while he was on a heart and lung machine. Quinn used three guiding sutures to position the device, and then a balloon and warm saline to seal it in place.

Because no stitches were needed, implanting the valve took about 20 minutes, says Quinn, compared to about an hour for other valves that are held in place with 18 to 24 sutures.

This means patients spend less time on the heart-lung bypass machine and generally have a shorter recovery, says Quinn. This time saving is particularly important when concomitant procedures, such as coronary bypass or mitral valve repair, are performed, he says.

In addition, the lack of sutures means there is added artery width for blood flow, Quinn says, as well as opportunity for a valve-in-valve transcatheter aortic valve replacement (TAVR), should the original wear down.

The valve Quinn used was approved by the Food and Drug Administration in January 2016. Quinn, who teaches other surgeons as a master proctor for the product, brought the replacement technique for the sutureless valve to Johns Hopkins when he joined Suburban Hospital from the Maine Medical Center in 2023.

Contacted in early February, Miller said he was starting to feel strong again and was back to exercising.