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Ann Thorac Surg 2005;80:198-203
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Midterm Results After Aortic Valve Replacement With a Stentless Bioprosthesis Aortic Valve

^a Department of Cardiothoracic Surgery, Klinikum Krefeld, Krefeld, Germany
^b Department of Cardiovascular Surgery, Justus Liebig University, Giessen, Germany

Accepted for publication January 7, 2005.

^_* Address reprint requests to Dr Martinovic, Am Oberend 11, 47809 Krefeld, Germany (Email: ivomartino{at}aol.com).

BACKGROUND: It is suggested that a simplified implant model Cryolife-O’Brien (CryoLife International, Kennesaw, GA) offers less satisfactory outcome compared with standard stentless models. This study was conducted to prospectively evaluate the midterm results after aortic valve replacement with the Cryolife-O’Brien stentless bioprosthesis.

METHODS: In 1996, a prospective clinical trial using different stentless valves was initiated. From September 1996 through September 2002, 156 consecutive patients with a mean age of 74.5 years underwent aortic valve replacement with the Cryolife-O’Brien porcine stentless bioprosthesis. The predominant aortic valve lesion was stenosis in 128 and insufficiency in 28 cases. Patients have been followed from 2 to 72 months (mean, 42 months). Echocardiography was performed by one echocardiographer preoperatively, intraoperatively, postoperatively at discharge, 2 to 6 months later, and annually thereafter.

RESULTS: Sixty percent of patients received a valve 25 mm in diameter or larger; 39% had concomittant coronary bypass grafting. The 30-day operative mortality rate was 6.4%. Ten late nonvalve-related deaths have occurred. Severe aortic insufficiency caused by oversizing leads to early reoperation in 3 patients. The peak and mean systolic gradients decreased significantly during the first 12 months after implantation, p < 0.001, and the effective valve areas increased significantly during this time interval p < 0.001. At 5 years, ten patients have moderate aortic insufficiency. The actuarial survival at 5 years was 88 ± 3%. The rate for freedom from endocarditis was 100% and for freedom from thromboembolic events was 94%.

CONCLUSIONS: Midterm results after aortic valve replacement with the Cryolife-O‘Brien stentless bioprosthesis are encouraging. Good hemodynamics have been coupled with low rate of valve-related complications, thus representing a very good alternative to conventional stented bioprostheses.

This article has been cited by other articles:

				D. Pavoni, L. P. Badano, F. Ius, E. Mazzaro, R. Frassani, S. Gelsomino, and U. Livi Limited Long-Term Durability of the Cryolife O'Brien Stentless Porcine Xenograft Valve Circulation, September 11, 2007; 116(11_suppl): I-307 - I-313. [Abstract] [Full Text] [PDF]