HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mario Vrandecic Fernando Antonio Fantini Bayard Gontijo Filho Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vrandecic, M. Articles by Vrandecic, E. Search for Related Content PubMed PubMed Citation Articles by Vrandecic, M. Articles by Vrandecic, E.

Eur J Cardiothorac Surg 2000;18:46-53
© 2000 Elsevier Science NL

Retrospective clinical analysis of stented vs. stentless porcine aortic bioprostheses

Biocor Institute, Avenida Alameda da Serra, 217, Bairro Vila da Serra, Belo Horizonte, Minas Gerais 34000-000, Brazil

Received 6 September 1999; received in revised form 15 February 2000; accepted 21 February 2000.

Corresponding author. Tel.: +55-31-286-4322; fax: +55-31-286-4321
e-mail: biocor{at}biocor.com.br

Objective: The study was designed to compare hemodynamic performance, structural failure and survival of patients undergoing aortic valve replacement (AVR) with a composite aortic stented or stentless porcine bioprosthesis. Methods: From January 1990 to June 1999, the clinical data of 725 patients undergoing AVR with stented porcine aortic bioprosthesis were reviewed. We defined two groups of patients with similar clinical characteristics: 202 patients receiving aortic stented and 205 patients stentless valves. The two patients groups were similar in age, sex, valve lesion, valve size, preoperative New York Heart Association (NYHA) class status and follow-up. Results: The number of patients available for follow-up, excluding hospital and late mortality, reoperations and patients lost to follow-up, was 157 for the stented and 175 for the stentless group. There was a higher incidence of rheumatic heart disease in the stented (59%) vs. stentless group (44%), (P=0.003). Fewer patients had prior aortic bioprosthetic dysfunction in the stented (7.6%) compared to the stentless group (25%) (P<0.001). The mean intensive care unit stay, hospital mortality and late mortality were similar (P, NS). The total complication rate was higher in the stented (12%) than the stentless (3.4%)(P=0.005). Valve related death was higher in the stented (2.5%) than the stentless (0%) (P=0.049). Postoperatively, the aortic effective orifice area (AEOA) was larger (P<0.001) and the transvalvular peak and mean gradients were lower in the stentless group (P<0.001). The leaflet tissue degeneration analysis was 8.0% in patients at risk for stented and 0.6% for stentless (P=0.001). Actuarial analysis disclosed no statistical difference in patient survival between groups (P=0.18). Reoperations were less frequent in the stentless group (P=0.010). Conclusions: Hemodynamic benefits in the stentless group were evident and expressed by larger AEOA, lower gradients, better left ventricular remodeling with significant decrease of the left ventricular mass. Lower complication rates, lower reoperation rates, less leaflet tissue degeneration, and lower valve related mortality rates were seen in the stentless group. A controlled clinical comparison trial with longer follow-up will be required to confirm these clinical and hemodynamic benefits.

Key Words: Porcine aortic stented bioprosthesis • Stentless aortic heart valve • Heterologous tissue heart valve • Tissue heart valve substitutes

This article has been cited by other articles:

				G. Polvani, F. Barili, L. Dainese, M. Muratori, M. Porqueddu, A. Sala, and P. Biglioli Long-Term Results After Aortic Valve Replacement With the Bravo 400 Stentless Xenograft Ann. Thorac. Surg., August 1, 2005; 80(2): 495 - 501. [Abstract] [Full Text] [PDF]

				J. Ennker, U. Rosendahl, I. C. Ennker, S. Bauer, and I. Florath Risk in Elderly Patients After Stentless Versus Stented Aortic Valve Surgery Asian Cardiovasc Thorac Ann, March 1, 2003; 11(1): 37 - 41. [Abstract] [Full Text] [PDF]

				D. B. Doty and J. R. Doty Stentless Aortic Valve Replacement: Bioprostheses Card. Surg. Adult, January 1, 2003; 2(2003): 889 - 898. [Full Text]

				G. B. Luciani, G. Casali, S. Auriemma, F. Santini, and A. Mazzucco Survival after stentless and stented xenograft aortic valve replacement: a concurrent, controlled trial Ann. Thorac. Surg., November 1, 2002; 74(5): 1443 - 1449. [Abstract] [Full Text] [PDF]