title: Clinical and hemodynamic evaluation of 21 mm and 23 mm Cryolife-O'Brien stentless bioprostheses implanted in the aortic position.
abstract: BACKGROUND
  The aim of this study was to investigate early and mid-term results after aortic valve replacement with Cryolife-O'Brien stentless bioprosthesis, model 300.
  
  
  METHODS
  Records of 59 patients who received a 21 or 23 mm (Group A) aortic Cryolife-O'Brien stentless valve were retrospectively reviewed and compared to 54 patients who received a valve > or = 25 mm (Group B). Group A patients were mainly female (p < 0.001), were older (p = 0.034), had dominant aortic stenosis (p = 0.011), and a smaller (p < 0.001) body surface area. Effective orifice area index was larger (p = 0.041) and left ventricular mass index higher (p = 0.024) in Group B.
  
  
  RESULTS
  The actuarial survival at 5.5 years was 94.9 +/- 2.3% and 92.5 +/- 4.3% in Group A and B respectively (p = NS). The actuarial freedom from all events was 85.1 +/- 6.1% and 88.2 +/- 5.2% in Group A vs Group B respectively (p = NS). At late echocardiographic studies performed between 4 and 42 months (mean 27.3 +/- 6.1 months) postoperatively, peak and mean gradients decreased and effective orifice area index increased over the follow-up period (p = NS between groups). Left ventricular mass index decreased by 25% (p < 0.001) in Group A and by 20% (p < 0.001) in Group B from preoperatively and a further 13% (p = 0.034) and 8.5% (p = 0.004), respectively, from the early to the late study. No significant difference in left ventricular mass regression was noticed between groups (p = NS).
  
  
  CONCLUSIONS
  The Cryolife-O'Brien porcine stentless bioprosthesis showed satisfactory mid-term results and may represent a good choice for patients with a small aortic annulus selected for a biological valve.
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital S. Maria della Misericordia, Udine, Italy. sandrogelsomino@virgilio.it
authors.forename: S
authors.initials: S
authors.lastname: Gelsomino
authors.forename: R
authors.initials: R
authors.lastname: Frassani
authors.forename: L
authors.initials: L
authors.lastname: Porreca
authors.forename: G
authors.initials: G
authors.lastname: Morocutti
authors.forename: U
authors.initials: U
authors.lastname: Livi
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D001705:Bioprosthesis; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D015996:Survival Rate