Risk in elderly patients after stentless versus stented aortic valve surgery.
Recent studies suggest that the hemodynamic advantage of stentless bioprostheses over the stented type improves long-term survival after aortic valve replacement, but the more complex and time-consuming implantation technique may increase the risks of operative death and postoperative complications. Between April 1996 and June 2001, 519 patients with a mean age of 76 +/- 5 years underwent aortic valve replacement using a stentless (Medtronic Freestyle, n = 277) or stented bioprosthesis (Medtronic Mosaic, n = 242). Multiple logistic regression analysis considering different patient populations revealed no increased risk of operative death, postoperative complications, or neurological impairment after implantation of a stentless bioprosthesis. Survival curves in respect of 367 patients who underwent aortic valve replacement up to September 2000 and were followed up for 3 years were not different (p = 0.98). As the patients were elderly, improved survival due to implantation of a stentless valve could not be demonstrated within this time span.
Ennker
Jürgen
J
Heart Institute Lahr/Baden, Lahr, Germany. ennker@heart-lahr.com
Rosendahl
Ulrich
U
Ennker
Ina Carolin
IC
Bauer
Stefan
S
Florath
Ines
I
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications; D011474:Prosthesis Design; D012306:Risk; D015607:Stents; D016019:Survival Analysis