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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2002 June;43(3):313-7

language: English

Hemodynamic performance after stented vs stentless aortic valve replacement

Jasinski M. J., Hayton J., Kadziola Z., Wos S., Sosnowski A. W.

From ­the Glenfield General Hospital, Leicester, UK and 2nd Department Cardiac Surgery, Katowice, Poland


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Background. Stentless bio­pros­the­ses ­are antic­i­pat­ed to ­cause ­improved hemo­dy­nam­ics ­and ­increased lon­gev­ity ­over stent­ed bio­pros­the­sis. We ­have com­pared echoc­ar­di­o­graph­ic anal­y­sis of stent­ed bio­pros­the­sis “Freestyle” ­with stent­ed “Mosaic” bio­pros­the­sis. Because of sim­i­lar tech­nol­o­gy (0 pres­sure fix­a­tion, anti­cal­cifi­ca­tion) ­any dif­fer­enc­es ­may ­relate to ­stent.
Methods. Twenty-eight ­patients under­go­ing ­AVR ­were ran­dom­ly ­assigned to ­receive ­either stent­ed or stent­less. Echocardiograms, by ­means of M-­mode ­and Doppler ­were per­formed ear­ly, 3-6 ­months ­and 1 ­year post­op­er­a­tive­ly.
Results. The ­peak ­flow veloc­ity ­was sig­nif­i­cant­ly low­er in ­the stent­less ­group, espe­cial­ly 1 ­week ­and 6 ­months ­after sur­gery. Mean trans­val­vu­lar gra­di­ent ­dropped sig­nif­i­cant­ly in stent­less ­group ­and ­did ­not ­change in stent­ed ­group. ­EOA ­did ­not ­change sig­nif­i­cant­ly in ­either of ­groups. AoV veloc­ity ­time inte­gral ­was increas­ing in stent­less ­group. LV ­mass ­had fal­len sig­nif­i­cant­ly in ­both ­groups ­but ­degree of ­mass reduc­tion ­was com­par­able.
Conclusions. There ­are ­marked improve­ments of stent­less ­valves hemo­dy­nam­ics. However it is ­not nec­es­sary ­equal to high­er ­degree of LV ­mass reduc­tion dur­ing 1 ­year fol­low-up.

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