| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;73:767-778
© 2002 The Society of Thoracic Surgeons
a Division of Cardiovascular Surgery, Sunnybrook and Women’s College Health Sciences Centre, and the University of Toronto, Toronto, Ontario, Canada
* Address reprint requests to Dr Christakis, Sunnybrook and Women’s College Health Sciences Centre, H-406, 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5
e-mail: george.christakis{at}swchsc.on.ca
Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.
Background. Although stentless aortic bioprostheses are believed to offer improved outcomes, hemodynamic benefits remain unsubstantiated.
Methods. Fifty-three patients were randomized to receive the stented C-E pericardial valve (CE) and 46 patients the Toronto Stentless Porcine valve (SPV). Annuli were sized for the optimal insertion of both valve types, such that surgeons were required to commit to specific valve sizes before randomization. Echocardiographic measurements and functional status (Duke Activity Status Index) were assessed at 3 and 12 months postoperatively.
Results. Although cardiopulmonary bypass times (CE: 118.6 ± 36.3 minutes; SPV: 148.5 ± 30.9 minutes; p = 0.0001) and aortic cross-clamp times (CE: 95.4 ± 28.6 minutes; SPV: 123.6 ± 24.1 minutes; p = 0.0001) were significantly prolonged in the SPV group, perioperative morbidity and mortality was similar between groups. Neither valve offered a superior internal diameter for any given annular diameter (mean decrease in left ventricular outflow tract diameter after valvular implantation: SPV: 3.4 ± 1.11 mm versus CE: 3.7 ± 1.33 mm;E p = 0.25). Although labeled mean valve size was significantly larger in the SPV group, the actual mean valve size based on internal valvular diameter was no different between groups (CE: 21.9 ± 2.0 mm; SPV: 22.3 ± 2.0 mm; p = 0.286). Although effective orifice areas increased, and mean and peak transvalvular gradients decreased in both groups over time, no differences were demonstrated between groups at 12 months. Similarly, although significant regression of left ventricular mass was accomplished in both groups over time, no differences were demonstrated between groups. Finally, Duke Activity Status Index scores of functional status improved in both groups over time; however, no differences were noted between groups at 12 months postoperatively.
Conclusions. Although offering excellent outcomes, stentless valves did not demonstrate superior hemodynamic indices in comparison to stented valves up to 12 months after implantation.
Related Article
Ann. Thorac. Surg. 2002 73: 778.
This article has been cited by other articles:
|
|
 |
|
  D. Wendt, M. Thielmann, T. Buck, R.-A. Janosi, T. Bossert, N. Pizanis, M. Kamler, and H. Jakob First clinical experience and 1-year follow-up with the sutureless 3F-Enable aortic valve prosthesis Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 542 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. David, C. M. Feindel, J. Bos, J. Ivanov, and S. Armstrong Aortic valve replacement with Toronto SPV bioprosthesis: Optimal patient survival but suboptimal valve durability J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 19 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. D. Desai and G. T. Christakis Bioprosthetic Aortic Valve Replacement: Stented Pericardial and Porcine Valves Card. Surg. Adult, January 1, 2008; 3(2008): 857 - 894. [Full Text]
|
|
|
|
 |
|
 A. Kallikourdis and S. Jacob Is a stentless aortic valve superior to conventional bioprosthetic valves for aortic valve replacement? Interactive CardioVascular and Thoracic Surgery, October 1, 2007; 6(5): 665 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Dunning, R.J. Graham, J. Thambyrajah, M.J. Stewart, S.W.H. Kendall, and S. Hunter Stentless vs. stented aortic valve bioprostheses: a prospective randomized controlled trial Eur. Heart J., October 1, 2007; 28(19): 2369 - 2374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Lehmann, T. Walther, J. Kempfert, S. Leontjev, A. Rastan, V. Falk, and F. W. Mohr Stentless Versus Conventional Xenograft Aortic Valve Replacement: Midterm Results of a Prospectively Randomized Trial Ann. Thorac. Surg., August 1, 2007; 84(2): 467 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Kunadian, K. Vijayalakshmi, A. R. Thornley, M. A. de Belder, S. Hunter, S. Kendall, R. Graham, M. Stewart, J. Thambyrajah, and J. Dunning Meta-Analysis of Valve Hemodynamics and Left Ventricular Mass Regression for Stentless Versus Stented Aortic Valves Ann. Thorac. Surg., July 1, 2007; 84(1): 73 - 78. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ali, J. C. Halstead, F. Cafferty, L. Sharples, F. Rose, E. Lee, R. Rusk, J. Dunning, V. Argano, and S. Tsui Early Clinical and Hemodynamic Outcomes After Stented and Stentless Aortic Valve Replacement: Results From a Randomized Controlled Trial Ann. Thorac. Surg., June 1, 2007; 83(6): 2162 - 2168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Bridges, S. M. O'Brien, J. C. Cleveland, E. B. Savage, J. S. Gammie, F. H. Edwards, E. D. Peterson, and F. L. Grover Association between indices of prosthesis internal orifice size and operative mortality after isolated aortic valve replacement J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1012 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Chambers, H. M. Rimington, R. Rajani, F. Hodson, and F. Shabbo A randomized comparison of the Cryolife O'Brien and Toronto stentless replacement aortic valves J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1045 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Yadav, A. J. Hodge, A. D. Hilless, and P. D. Skillington Outcomes with Toronto stentless porcine aortic valve: the Australian experience Interactive CardioVascular and Thoracic Surgery, December 1, 2006; 5(6): 709 - 715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Chatel, C. Mica, D. Blanchard, F. Baud, D. Bruere, A. Maudiere, and P. Peycher Short-term hemodynamic advantages of stentless CryoLife-O'Brien valve over stented bioprostheses for aortic valve replacement Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 578 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Cohn Evidence-based cardiac surgery J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 457 - 458. [Full Text] [PDF]
|
|
|
|
 |
|
 R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ali, J. C. Halstead, F. Cafferty, L. Sharples, F. Rose, R. Coulden, E. Lee, J. Dunning, V. Argano, and S. Tsui Are Stentless Valves Superior to Modern Stented Valves?: A Prospective Randomized Trial Circulation, July 4, 2006; 114(1_suppl): I-535 - I-540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Dalmau, J. MariaGonzalez-Santos, J. Lopez-Rodriguez, M. Bueno, and A. Arribas The Carpentier-Edwards Perimount Magna aortic xenograft: a new design with an improved hemodynamic performance Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 263 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Chambers, H. M. Rimington, F. Hodson, R. Rajani, and C. I. Blauth The subcoronary Toronto stentless versus supra-annular Perimount stented replacement aortic valve: Early clinical and hemodynamic results of a randomized comparison in 160 patients J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 878 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Borger, S. M. Carson, J. Ivanov, V. Rao, H. E. Scully, C. M. Feindel, and T. E. David Stentless Aortic Valves are Hemodynamically Superior to Stented Valves During Mid-Term Follow-Up: A Large Retrospective Study Ann. Thorac. Surg., December 1, 2005; 80(6): 2180 - 2185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Perez de Arenaza, B. Lees, M. Flather, F. Nugara, T. Husebye, M. Jasinski, M. Cisowski, M. Khan, M. Henein, J. Gaer, et al. Randomized Comparison of Stentless Versus Stented Valves for Aortic Stenosis: Effects on Left Ventricular Mass Circulation, October 25, 2005; 112(17): 2696 - 2702. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tamim, T. Bove, Y. Van Belleghem, K. Francois, Y. Taeymans, and G. J Van Nooten Stentless vs. Stented Aortic Valve Replacement: Left Ventricular Mass Regression Asian Cardiovasc Thorac Ann, June 1, 2005; 13(2): 112 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Amarelli, A. Della Corte, G. Romano, G. Iasevoli, G. Dialetto, L. S. De Santo, M. De Feo, M. Torella, M. Scardone, and M. Cotrufo Left ventricular mass regression after aortic valve replacement with 17-mm St Jude Medical mechanical prostheses in isolated aortic stenosis J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 512 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Doss, S. Martens, J. P. Wood, A. Miskovic, T. Christodoulou, G. Wimmer-Greinecker, and A. Moritz Aortic Leaflet Replacement With the New 3F Stentless Aortic Bioprosthesis Ann. Thorac. Surg., February 1, 2005; 79(2): 682 - 685. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Rahimtoola The year in valvular heart disease J. Am. Coll. Cardiol., January 4, 2005; 45(1): 111 - 122. [Full Text] [PDF]
|
|
|
|
|
|
N. D. Desai, O. Merin, G. N. Cohen, J. Herman, S. Mobilos, J. Y. Sever, S. E. Fremes, B. S. Goldman, and G. T. Christakis Long-Term Results of Aortic Valve Replacement With the St. Jude Toronto Stentless Porcine Valve Ann. Thorac. Surg., December 1, 2004; 78(6): 2076 - 2083. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Halstead and S. S. Tsui Randomized trial of stentless versus stented bioprostheses for aortic valve replacement Ann. Thorac. Surg., October 1, 2003; 76(4): 1338 - 1339. [Full Text] [PDF]
|
|
|
|
|
|
S. C. Gauthier, J. G. Barton, M. M. Lane, and R. C. Elkins Pulmonary autografts in patients with severe left ventricular dysfunction Ann. Thorac. Surg., September 1, 2003; 76(3): 689 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Pibarot and J. G. Dumesnil Is the hemodynamic performance of the carpentier-edwards perimount valve really equivalent to that of stentless valves? Ann. Thorac. Surg., August 1, 2003; 76(2): 656 - 657. [Full Text] [PDF]
|
|
|
|
|
|
G. Cohen Reply Ann. Thorac. Surg., August 1, 2003; 76(2): 657 - 658. [Full Text] [PDF]
|
|
|
|
|
|
O. Lund, K. Emmertsen, I. Dorup, F. T. Jensen, and C. Flo Regression of left ventricular hypertrophy during 10 years after valve replacement for aortic stenosis is related to the preoperative risk profile Eur. Heart J., August 1, 2003; 24(15): 1437 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Doss Reply to Walther and Falk Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 335 - 336. [Full Text] [PDF]
|
|
|
|
|
|
M. Doss, S. Martens, J.P. Wood, T. Aybek, P. Kleine, G. Wimmer Greinecker, and A. Moritz Performance of stentless versus stented aortic valve bioprostheses in the elderly patient: a prospective randomized trial Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 299 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Desai and G. T. Christakis Stented Mechanical/Bioprosthetic Aortic Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 825 - 856. [Full Text]
|
|
|
|
|
|
S. Bevilacqua, J. Gianetti, A. Ripoli, U. Paradossi, A. Giuseppe Cerillo, M. Glauber, M. L. Sacha Matteucci, M. Senni, A. Gamba, E. Quaini, et al. Aortic valve disease with severe ventricular dysfunction: stentless valve for better recovery Ann. Thorac. Surg., December 1, 2002; 74(6): 2016 - 2021. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
