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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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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