| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2007;84:73-78
© 2007 The Society of Thoracic Surgeons
The James Cook University Hospital, Middlesbrough, United Kingdom
Accepted for publication February 14, 2007.
* Address correspondence to Dr Kunadian, c/o Mr Dunning, Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough TS4 3BW, UK (Email: babu.kunadian{at}stees.nhs.uk).
Background: Stentless aortic bioprostheses have been advocated as being superior to conventional bioprosthetic valves, with benefits including superior left ventricular mass regression and larger effective orifice area. Several high-quality randomized studies now exist on this topic, and we sought to summarize them by meta-analysis.
Methods: The literature was searched from 1995 to 2006, in MEDLINE, EMBASE, CRISP, metaRegister of Controlled Trials, and the Cochrane database. Experts were also contacted and reference lists searched. Studies were combined using the inverse variance fixed-effects model. Heterogeneity was assessed and a sensitivity analysis performed. Publication bias was also investigated.
Results: Ten studies were identified that included 919 patients in which the Freedom (Sorin Biomedica Cardio, Via Crescentino, Italy), Freestyle (Medtronic, Minneapolis, MN), Prima Plus (Edwards Life Sciences, Irvine, CA) and the Toronto and Biocor (St Jude Medical, St. Paul, MN) valves were used. The mean aortic valve gradient was lower in the stentless groups, with a weighted mean difference (WMD) of –3.57 mm Hg (95% confidence interval [CI], –4.36 to –2.78; p < 0.01). The left ventricular mass index was significantly lower in the stentless groups at 6 months (WMD, –6.42; 95% CI, –11.63 to –1.21; p = 0.02), but this improvement disappeared after 12 months (WMD, 1.19; 95% CI, –4.15 to 6.53; p = 0.66). The weighted mean increase in cross-clamp time was 23 minutes, and the increase in bypass time was 29 minutes with a stentless valve.
Conclusions: This meta-analysis showed that stentless aortic valves provide an improved level of left ventricular mass regression at 6 months, reduced aortic gradients, and an improved effective orifice area index, at the expense of a 23-minute longer cross-clamp time and a 29-minute longer bypass time.
Related Article
Ann. Thorac. Surg. 2007 84: 78-79.
This article has been cited by other articles:
|
|
 |
|
  A. Repossini, M. Rambaldini, V. Lucchetti, U. Da Col, F. Cesari, C. Mignosa, E. Picano, and M. Glauber Early clinical and haemodynamic results after aortic valve replacement with the Freedom SOLO bioprosthesis (experience of Italian multicenter study) Eur J Cardiothorac Surg, February 6, 2012; (2012) ezr140v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Funder Current status on stentless aortic bioprosthesis: a clinical and experimental perspective Eur J Cardiothorac Surg, December 21, 2011; (2011) ezr141v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Donndorf, B. Westphal, and G. Steinhoff Early stenotic prosthesis failure after implantation of a stentless porcine aortic valve prosthesis Interact CardioVasc Thorac Surg, September 1, 2011; 13(3): 348 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Clavel, J. G. Webb, J. Rodes-Cabau, J. B. Masson, E. Dumont, R. De Larochelliere, D. Doyle, S. Bergeron, H. Baumgartner, I. G. Burwash, et al. Response to Letters Regarding Article, "Comparison Between Transcatheter and Surgical Prosthetic Valve Implantation in Patients With Severe Aortic Stenosis and Reduced Left Ventricular Ejection Fraction" Circulation, August 16, 2011; 124(7): e207 - e208. [Full Text] [PDF]
|
|
|
|
|
|
B. Murtuza, J. R. Pepper, C. Jones, P. Nihoyannopoulos, A. Darzi, and T. Athanasiou Does stentless aortic valve implantation increase perioperative risk? A critical appraisal of the literature and risk of bias analysis Eur J Cardiothorac Surg, May 1, 2011; 39(5): 643 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Cotoni, R. T. Palac, L. J. Dacey, and D. J. O'Rourke Defining Patient-Prosthesis Mismatch and Its Effect on Survival in Patients With Impaired Ejection Fraction Ann. Thorac. Surg., March 1, 2011; 91(3): 692 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Nozohoor and J. Sjogren Reply to Kestelli et al. Eur J Cardiothorac Surg, December 1, 2010; 38(6): 814 - 815. [Full Text] [PDF]
|
|
|
|
|
|
A. Kulik Aortic Root Enlargement: Worth the Effort? Ann. Thorac. Surg., September 1, 2010; 90(3): 703 - 705. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Cohen, B. Zagorski, G. T. Christakis, C. D. Joyner, J. Vincent, J. Sever, S. Harbi, R. Feder-Elituv, F. Moussa, B. S. Goldman, et al. Are stentless valves hemodynamically superior to stented valves? Long-term follow-up of a randomized trial comparing Carpentier-Edwards pericardial valve with the Toronto Stentless Porcine Valve J. Thorac. Cardiovasc. Surg., April 1, 2010; 139(4): 848 - 859. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Aymard, F. Eckstein, L. Englberger, M. Stalder, A. Kadner, and T. Carrel The Sorin Freedom SOLO stentless aortic valve: Technique of implantation and operative results in 109 patients J. Thorac. Cardiovasc. Surg., March 1, 2010; 139(3): 775 - 777. [Full Text] [PDF]
|
|
|
|
|
|
M. Scharfschwerdt, H.-H. Sievers, A. Hussein, E. G. Kraatz, and M. Misfeld Impact of progressive sinotubular junction dilatation on valve competence of the 3F Aortic and Sorin Solo stentless bioprosthetic heart valves Eur J Cardiothorac Surg, March 1, 2010; 37(3): 631 - 634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Gulbins and H. Reichenspurner Which Patients Benefit From Stentless Aortic Valve Replacement? Ann. Thorac. Surg., December 1, 2009; 88(6): 2061 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Suri, K. J. Zehr, T. M. Sundt III, J. A. Dearani, R. C. Daly, J. K. Oh, and H. V. Schaff Left Ventricular Mass Regression After Porcine Versus Bovine Aortic Valve Replacement: A Randomized Comparison Ann. Thorac. Surg., October 1, 2009; 88(4): 1232 - 1237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-L. Monin Prosthesis-patient mismatch: myth or reality? Heart, June 1, 2009; 95(11): 948 - 952. [Full Text] [PDF]
|
|
|
|
|
|
A. Germing and A. Mugge What the cardiac surgeon needs to know prior to aortic valve surgery: impact of echocardiography Eur J Cardiothorac Surg, June 1, 2009; 35(6): 960 - 964. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J G Dumesnil, J Magne, N Girerd, and P Pibarot Moderate patient-prosthesis mismatch can impact on mortality after aortic valve replacement Heart, April 1, 2009; 95(7): 592 - 592. [Full Text] [PDF]
|
|
|
|
|
|
P. Pibarot and J. G. Dumesnil Prosthetic Heart Valves: Selection of the Optimal Prosthesis and Long-Term Management Circulation, February 24, 2009; 119(7): 1034 - 1048. [Full Text] [PDF]
|
|
|
|
|
|
M. R. Moon, J. S. Lawton, N. Moazami, N. A. Munfakh, M. K. Pasque, and R. J. Damiano Jr. POINT: Prosthesis-patient mismatch does not affect survival for patients greater than 70 years of age undergoing bioprosthetic aortic valve replacement. J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 278 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. Stansfield, P. C. Charles, R.-h. Tang, M. Rojas, R. Bhati, N. C. Moss, C. Patterson, and C. H. Selzman Regression of pressure-induced left ventricular hypertrophy is characterized by a distinct gene expression profile J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): 232 - 238. [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]
|
|
|
|
|
|
X. Y. Jin and C. Ratnatunga Invited commentary Ann. Thorac. Surg., July 1, 2007; 84(1): 78 - 79. [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 |
