Hemodynamic performance after stented vs stentless aortic valve replacement.
BACKGROUND
Stentless bioprostheses are anticipated to cause improved hemodynamics and increased longevity over stented bioprosthesis. We have compared echocardiographic analysis of stented bioprosthesis "Freestyle" with stented "Mosaic" bioprosthesis. Because of similar technology (0 pressure fixation, anticalcification) any differences may relate to stent.


METHODS
Twenty-eight patients undergoing AVR were randomly assigned to receive either stented or stentless. Echocardiograms, by means of M-mode and Doppler were performed early, 3-6 months and 1 year postoperatively.


RESULTS
The peak flow velocity was significantly lower in the stentless group, especially 1 week and 6 months after surgery. Mean transvalvular gradient dropped significantly in stentless group and did not change in stented group. EOA did not change significantly in either of groups. AoV velocity time integral was increasing in stentless group. LV mass had fallen significantly in both groups but degree of mass reduction was comparable.


CONCLUSIONS
There are marked improvements of stentless valves hemodynamics. However it is not necessary equal to higher degree of LV mass reduction during 1 year follow-up.
Jasinski
M J
MJ
Glenfield General Hospital, Leicester, UK. Marekjas@hotmail.com
Hayton
J
J
Kadziola
Z
Z
Wos
S
S
Sosnowski
A W
AW
D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D001783:Blood Flow Velocity; D004452:Echocardiography; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D011446:Prospective Studies; D015607:Stents; D013997:Time Factors