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Eur J Cardiothorac Surg 2003;24:335
© 2003 Elsevier Science NL

Letter to the Editor

Prospectively randomized evaluation of stented versus stentless aortic valve bioprostheses

Heart Center, University of Leipzig, Department of Cardiac Surgery, Strümpellstrasse 39, 04289 Leipzig, Germany

Received 17 March 2003; accepted 14 April 2003.

^* Corresponding author. Tel.: +49-341-865-1424; fax: +49-341-865-1452
e-mail: walt{at}medizin.uni-leipzig.de

Key Words: Aortic valve replacement • Stentless bioprosthesis

With interest we read the recent article by Doss et al. [1] where they found no differences between the two xenografts implanted. This led them to a clear and well-considered conclusion that stentless aortic valve replacement does not appear to be justified in elderly patients. However, some aspects require further consideration.

Doss et al. describe a series of 40 patients divided into two groups of 20 patients each. They do not give any information on whether statisticians had calculated this number of patients to allow for meaningful analysis. The implanted valve size of 23 mm is the only subgroup where minimal requirements of at least ten patients per valve size are scarcely reached. Results on intraoperatively measured annular diameters to allow for true comparisons are not given. Furthermore, the article lacks information on indexed differences of left ventricular mass.

It is well accepted that regression of left ventricular hypertrophy occurs after conventional stented as well as after stentless aortic valve replacement. By means of a prospectively randomized trial on a larger cohort of patients, significantly enhanced left ventricular mass regression had been proven after stentless aortic valve replacement [2]. Whether enhanced left ventricular mass regression translates into improved long-term survival remains speculative at present.

References

1. Doss M., Martens S., Wood P., Aybek T., Kleine P., Wimmer-Greinecker G., Moritz A. Performance of stentless versus stented aortic valve bioprostheses in the elderly patient: a prospective randomized trial. Eur J Cardiothorac Surg 2003;23:299-304.[Abstract/Free Full Text]
2. Walther T., Falk V., Langebartels G., Krüger M., Bernhardt U., Diegeler A., Gummert J., Autschbach R., Mohr F.W. Prospectively randomized evaluation of stentless versus conventional biological aortic valves: impact on early regression of left ventricular hypertrophy. Circulation 1999;100(19 Suppl):II6-II10.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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): Thomas Walther Volkmar Falk Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Walther, T. Articles by Falk, V. Search for Related Content PubMed PubMed Citation Articles by Walther, T. Articles by Falk, V. Related Collections Valve disease