Document Detail


Survival after stentless and stented xenograft aortic valve replacement: a concurrent, case-match trial.
MedLine Citation:
PMID:  15185887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In order to compare the long-term outcome of stented vs stentless aortic xenografts, a non-randomized, concurrent case-match trial was conducted on all consecutive patients operated between January 1992 and April 2000. METHODS: Two hundred and ninety-two patients had stented (group 1) and 376 stentless (group 2) xenograft aortic valve replacement (AVR). Group 1 patients were older (75.0 +/- 4.1 vs 70.4 +/- 6.7 years, p = 0.01), while male gender and aortic stenosis were equally prevalent. NYHA functional class III-IV (85 vs 78%, p = 0.03) and associated procedures (53 vs 41%, p = 0.01) were more common in group 1. The aortic cross-clamping (79.7 +/- 27.8 vs 96.1 +/- 23.3, p = 0.001) and bypass (91.4 +/- 57.5 vs 128.5 +/- 34.0, p = 0.002) times were shorter in group 1. A case-match analysis identified 113 identical patient pairs, on the basis of age, gender, diagnosis, NYHA class, associated cardiac disease, and valve size. RESULTS: The early mortality was higher in group 1 (5.3 vs 2.7%, p = 0.3), though not significantly. During follow-up (37 +/- 30 vs 43 +/- 35 months, p = 0.6), 26 late deaths were recorded (10.3 vs 13.6%, p = 0.4). The 8-year survival was comparable (76 +/- 7 vs 75 +/- 5%, p = 0.2), but freedom from cardiac (77 +/- 7 vs 90 +/- 4%, p = 0.02) and from valve-related death (78 +/- 7 vs 91 +/- 4%, p = 0.02) was higher in group 2. Freedom from structural deterioration (99 +/- 1 vs 98 +/- 2%, p = 0.7) and from reoperation (99 +/- 1 vs 95 +/- 3%, p = 0.2) at 8 years was similar. The late functional status was equally satisfactory (NYHA class I-II 92.7 vs 94.7%, p = 0.06). CONCLUSIONS: The survival free from cardiac and valve-related mortality when stentless xenografts for AVR are used is superior to that achieved with stented grafts. Stentless AVR has the potential of conferring selective survival advantages late after operation.
Authors:
Gianluca Casali; Stefano Auriemma; Francesco Santini; Alessandro Mazzucco; Giovanni Battista Luciani
Related Documents :
15226987 - Two years' experience with the duromedics bileaflet heart valve prosthesis.
4028357 - Clinical comparison of st. jude and porcine aortic valve prostheses.
12607647 - Late follow-up of 1095 patients undergoing operation for complex congenital heart disea...
1934447 - Long-term results of aortic valve replacement with nonviable homografts.
21868007 - Semen quality and fertility in adult long-term survivors of childhood acute lymphoblast...
21145637 - The incidence of periodontal defects distal to the maxillary second molar after impacte...
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  5     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-06-09     Completed Date:  2004-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  282-9     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, University of Verona, Verona, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve / surgery*
Bioprosthesis*
Cross-Sectional Studies
Female
Follow-Up Studies
Heart Valve Diseases / surgery*
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation*
Hospital Mortality
Humans
Male
Matched-Pair Analysis
Stents*
Survival Rate
Time Factors
Treatment Outcome

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


Previous Document:  Randomized trial of conventional balloon angioplasty versus cutting balloon for in-stent restenosis....
Next Document:  Analysis of Y-graft blood flow and flow reserve in conditions of increased myocardial oxygen consump...