Stentless vs. stented aortic valve bioprostheses: a prospective randomized controlled trial
2007; Oxford University Press; Volume: 28; Issue: 19 Linguagem: Inglês
10.1093/eurheartj/ehm327
ISSN1522-9645
AutoresJoel Dunning, Richard Graham, Jeetendra Thambyrajah, Michael J. Stewart, Simon Kendall, Steven Hunter,
Tópico(s)Cardiovascular Function and Risk Factors
ResumoWe sought to assess the haemodynamic profile of the Freedom stentless aortic valve compared with a stented bioprosthesis in a randomized controlled trial using echocardiography. Sixty patients (mean age 73 years) undergoing bioprosthetic aortic valve replacement (AVR) were randomized to either Sorin Freedom stentless (n = 31) or Sorin More stented (n = 29) valves. The primary endpoints were left ventricular mass index (LVMI) reduction at 6 and 12-months. We also assessed post-operative effective orifice area index (EOAI), aortic gradient and operative time. There were no significant differences in baseline characteristics. The stentless valve was associated with a lower post-operative gradient [PG 17 (12) vs. 31 (13) mmHg, P < 0.0001] and greater EOAI [1.1 (0.3) vs. 0.8 (0.2) cm2/m2, P < 0.0001]. A highly significant reduction in LVMI occurred by 6 months in both groups, but LVMI was significantly lower in the stentless group [LVMI 119 (39) vs. 135 (30) g/m2, P = 0.05]. However, there was continued regression of left ventricular hypertrophy (LVH) in the stented but not in the stentless group, resulting in no significant difference in LVMI at 12 months [119 (36) vs. 126 (31) g/m2, P = 0.42]. The use of the Sorin Freedom stentless bioprosthesis for AVR results in lower PG and greater EOA when compared with a Sorin More stented valve. This is associated with earlier regression of LVH.
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