Document Detail


Prospective randomized evaluation of stentless vs. stented aortic biologic prosthetic valves in the elderly at five years.
MedLine Citation:
PMID:  19126556     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Randomized trials comparing stentless to stented bioprostheses for aortic valve replacement in elderly are scarce. The aim of this study was early and mid-term evaluation of these bioprostheses, with regards to clinical outcome and hemodynamic performance. METHODS: Between September 1999 and January 2001, 40 patients with aortic stenosis, over the age of 75 years, were randomly assigned to receive either the stented Perimount (n=20) or the stentless Prima Plus (n=20) bioprosthesis. Clinical outcomes, left ventricular mass regression, effective orifice area, ejection fraction and mean gradients were evaluated at discharge, six months, one year and five years after surgery. RESULTS: At five years, there were 5/20 (25%) deaths in the stentless group and 6/20 (30%) deaths in the stented group (all non-valve-related). There was one case of endocarditis in each group, early postoperatively. Overall, a significant decrease in left ventricular mass was found five years postoperatively. However, there was no significant difference in the rate and completeness of LV-mass regression between the groups (LV mass index 114+/-34.1 vs. 120+/-27.2). Furthermore, hemodynamic performance of the valves (mean gradient of 9.9+/-4.8 mmHg vs. 10.2+/-4.2 mmHg) did not differ significantly between the groups. CONCLUSIONS: At five years, stentless valves were not superior to the stented valves, with regards to hemodynamic performance, regression of left ventricular mass and clinical outcome.
Authors:
Petar S Risteski; Sven Martens; Amin Rouhollahpour; Gerhard Wimmer-Greinecker; Anton Moritz; Mirko Doss
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-01-06
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  8     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-23     Completed Date:  2009-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  449-53     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. docpsr@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / complications,  physiopathology,  surgery*,  ultrasonography
Bioprosthesis*
Female
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation*
Hemodynamics
Humans
Hypertrophy, Left Ventricular / etiology,  ultrasonography
Male
Prospective Studies
Prosthesis Design
Stents*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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