Early postoperative outcome and hemodynamic performance of the sorin pericarbon stentless aortic valve.
OBJECTIVE
Stentless aortic bioprostheses offer potential advantages in terms of durability and hemodynamic performance. The study aim was to evaluate the early postoperative performance of the Sorin Pericarbon stentless bioprosthesis.


METHODS
Between November 1999 and December 2000, 34 patients (12 males, 22 females; mean age 71.2 +/- 4.8 years; range: 48-85 years) underwent aortic valve (AV) replacement with the Sorin Pericarbon stentless bioprosthesis. Twenty-two patients were in NYHA classes III-IV, and 12 were in classes I-II. Twenty-one patients had AV stenosis, nine AV regurgitation, and four mixed pathology. Doppler-echocardiography was performed before surgery, at hospital discharge and at six-month follow up. At this time, 20 patients also underwent echo-Doppler stress testing, with peak transvalvular gradient measured at rest and during exercise.


RESULTS
There were two hospital deaths (not valve-related). No significant perioperative complications were recorded. At hospital discharge, the aortic peak gradient was 15.7 +/- 10.6 mmHg; nil or trivial aortic regurgitation was found in three patients. During six months follow up no endocarditis or thromboembolic events were registered. At six months postoperatively, the transvalvular peak gradient showed a small but significant decrease (11.3 +/- 3.5 mmHg at six months, p = 0.036). Mean left ventricular mass index was also decreased significantly (118.4 +/- 28.5 versus 98.4 +/- 17.8 g/m2, p = 0.024). Left ventricular ejection fraction and effective orifice area were not changed significantly during follow up. In patients undergoing exercise testing (mean maximal workload 96 +/- 48 W), the peak aortic gradient was increased (not significantly) at exercise peak (from 14.7 +/- 6.5 to 17.2 +/- 6.7 mmHg, p = 0.086).


CONCLUSIONS
The excellent early postoperative outcome of this experience with the Sorin Pericarbon stentless valve encourages the use of this prosthesis. Long-term follow up and further evaluations are required with regard to hemodynamic performance and durability.
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors