Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Martinovic, I; Farah, I; Everlien, M; Knez, I; Greve, HP; Vogt, P.
Aortic valve replacement with the Cryolife-O'Brien stentless aortic bioprosthesis: five-year experience.
J Cardiovasc Surg (Torino). 2004; 45(6):557-563
Web of Science
PubMed
- Co-Autor*innen der Med Uni Graz
- Knez Igor
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- Abstract:
- Improved hemodynamics with stentless bioprosthesis compared to stented valves have been well documented. It has been suggested that a simplified implant model, the Cryolife-O'Brien, offers less satisfactory outcomes 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. In 1996, the prospective clinical trial using different stentless valves was initiated in our center. From September 1996 through August 2001, 132 consecutive patients with a mean age of 72.5 years underwent aortic valve replacement with the Cryolife-O'Brien porcine stentless bioprosthesis by the same surgeon. The predominant aortic valve lesion was stenosis in 110 cases and insufficiency in 22 cases. Patients have been followed-up from 2 to 60 months, mean 28 months. Echocardiography was performed by the same echocardiographer preoperatively, intraoperatively, postoperatively at discharge, 2 to 6 months later and annually thereafter. Sixty-five percent of patients received a valve 25 mm in diameter or larger, 42% had concomitant coronary bypass grafting. The 30-day operative mortality rate was 6.8 %. Nine late deaths, none related to the valve, have occurred. Severe aortic insufficiency caused by oversizing led 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). Eleven patients have aortic insufficiency, trivial in 7 and mild in 4. The actuarial survival at 5 years was 86+/-3%. The rate for freedom from endocarditis was 100% and for freedom from thromboembolic events 92%. The Cryolife-OBrien stentless bioprosthesis has superior hemodynamics and a low rate of valve-related complications thus representing a very good alternative to conventional stented bioprosthesis. The midterm results are encouraging but further follow-up is needed to determine the valve's durability.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aortic Valve - diagnostic imaging
- Aortic Valve - surgery
- Bioprosthesis -
- Equipment Failure Analysis -
- Female -
- Follow-Up Studies -
- Heart Valve Diseases - diagnostic imaging
- Heart Valve Diseases - mortality
- Heart Valve Diseases - surgery
- Heart Valve Prosthesis -
- Heart Valve Prosthesis Implantation -
- Humans -
- Male -
- Prospective Studies -
- Survival Rate -
- Treatment Outcome -
- Ultrasonography -
- Find related publications in this database (Keywords)
- aortic valve replacement
- stentless valves
- Cryolife-O'Brien
- echocardiography