PMID- 10869940
OWN - NLM
STAT- MEDLINE
DCOM- 20000908
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 18
IP  - 1
DP  - 2000 Jul
TI  - Retrospective clinical analysis of stented vs. stentless porcine aortic 
      bioprostheses.
PG  - 46-53
AB  - 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.
FAU - Vrandecic, M
AU  - Vrandecic M
AD  - Biocor Institute, Avenida Alameda da Serra, 217, Bairro Vila da Serra, Belo 
      Horizonte, 34000-000, Minas Gerais, Brazil. biocor@biocor.com.br
FAU - Fantini, F A
AU  - Fantini FA
FAU - Filho, B G
AU  - Filho BG
FAU - de Oliveira, O C
AU  - de Oliveira OC
FAU - da Costa Junior, I M
AU  - da Costa Junior IM
FAU - Vrandecic, E
AU  - Vrandecic E
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aortic Valve
MH  - *Bioprosthesis
MH  - Cardiopulmonary Bypass
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Hemodynamics
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
MH  - Retrospective Studies
MH  - Stents
MH  - Treatment Outcome
EDAT- 2000/06/28 11:00
MHDA- 2000/09/19 11:01
CRDT- 2000/06/28 11:00
PHST- 2000/06/28 11:00 [pubmed]
PHST- 2000/09/19 11:01 [medline]
PHST- 2000/06/28 11:00 [entrez]
AID - S1010-7940(00)00416-4 [pii]
AID - 10.1016/s1010-7940(00)00416-4 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2000 Jul;18(1):46-53. doi: 
      10.1016/s1010-7940(00)00416-4.