title: [Flexible aortic valve prostheses: long-term functional results with porcine bioprostheses without mechanical commissure stent and aortic homografts].
abstract: The long-term performance of two different types of flexible aortic prostheses was evaluated in 10 patients who received a stentless porcine prosthetic valve (group A) and in 18 patients who underwent aortic valve replacement with an aortic homograft (group B). In group A early postoperative angiography (5-16 days post surgery) revealed a mean gradient across the aortic prosthesis of 8 +/- 6 mmHg. Late postoperative Doppler echocardiography (3.2 +/- 0.9 years post surgery) suggested a mean gradient of 6 +/- 3 mmHg with a Doppler derived valve orifice area of 1.8 +/- 0.6 cm2. Color Doppler visualized mild prosthesis regurgitation in two of the 10 patients and two-dimensional imaging showed no significant leaflet calcification. In group B late postoperative Doppler echography (5.2 +/- 1.6 years post surgery) suggested a mean gradient of 11 +/- 14 mmHg with a mean graft orifice area of 1.8 +/- 0.5 cm2. Color Doppler revealed prosthesis regurgitation in 15 patients (severe 1, moderate 2, mild 12) and two-dimensional imaging visualized significant prosthesis leaflet calcification in two patients. The good hemodynamic function of a stentless porcine bioprosthesis which seems to be preserved for at least several years indicates that the use of the flexible aortic xenograft is worthwhile pursuing. The long-term performance of an aortic homograft is relatively poor and may be due to unsolved problems with regard to sterilizing and storing the valves.
authors.affiliation: Abteilung Kardiologie, Medizinischen Universitätsklinik Kiel.
authors.forename: B
authors.initials: B
authors.lastname: Hausmann
authors.forename: U
authors.initials: U
authors.lastname: Nellessen
authors.forename: M
authors.initials: M
authors.lastname: Höfig
authors.forename: M
authors.initials: M
authors.lastname: Mahmoodi
authors.forename: R
authors.initials: R
authors.lastname: Leyh
authors.forename: H H
authors.initials: HH
authors.lastname: Sievers
authors.forename: P
authors.initials: P
authors.lastname: Heintzen
authors.forename: A
authors.initials: A
authors.lastname: Bernhardt
authors.forename: R
authors.initials: R
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography
vernacular_title: Flexible Aortenklappenprothesen: Funktionelle Langzeitergebnisse porciner Bioprothesen ohne mechanische Kommissurenhalterung und aortaler Homografts.