Three years' experience with the sorin pericarbon stentless prosthesis: mid-term results with three different implantation techniques.
OBJECTIVE
Sorin Pericarbon stentless pericardial valves were implanted using three different surgical techniques, and early and mid-term clinical and hemodynamic results were analyzed according to the method used.


METHODS
Between January 2000 and December 2002, 102 Pericarbon stentless valves were implanted in 101 patients (55 females, 46 males; mean age 67.6+/-7.1 years). Among these patients, 63 had isolated aortic valve replacement and 39 underwent a combined procedure. The inflow portion of a matching-size prosthesis was fixed to the aortic annulus either by semi-continuous Prolene suture (n = 48), interrupted simple Ethibond (n = 29) or interrupted Ethibond mattress stitches (n = 25). Valve sizes were not significantly different in the three subgroups. The aortic cross-clamp and cardiopulmonary bypass times were 145+/-31 min and 171+/-39 min, respectively, with interrupted stitches; these times were significantly longer than in the continuous suture group (115+/-27 min and 143+/-45 min) or with interrupted mattress stitches (111+/-28 min and 137+/-34 min).


RESULTS
Early mortality was 6.8% (n = 7) for the entire patient group. None of the deaths was valve-related. Postoperatively, all patients were followed up (mean 26.6+/-9.4 months). There were two late deaths (both non-valve-related). One patient developed early endocarditis, and the infected valve was re-replaced with another Pericarbon stentless valve. During the follow up period the mean and peak transvalvular gradient was decreased from 12.8+/-8.5 mmHg to 9.1+/-2.3 mmHg and from 22.5+/-13.9 mmHg to 16.1+/-4.3 mmHg respectively, and left ventricular wall thickness from 15.5+/-2.1 mm to 12.8+/-1.4 mm. Regurgitation was not more than trivial for any of the implanted valves. The implantation technique did not significantly affect the hemodynamic performance of the Pericarbon stentless valve.


CONCLUSIONS
The Sorin Pericarbon stentless pericardial prosthesis showed excellent hemodynamic performance, even if implanted in a matching-size aortic root. The implantation technique used had no significant influence on valve performance.
Nagy
Zsolt L
ZL
Institute of Cardiology and Cardiac Surgery, University of Debrecen, Hungary. zsoltlnagy@hotmail.com
Bodi
Annamaria
A
Len
Andras
A
Balogh
Irma
I
Peterffy
Arpad
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011126:Polypropylenes; D011446:Prospective Studies; D011474:Prosthesis Design; D016019:Survival Analysis; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000601:surgery
C014534:Ethibond; D011093:Polyethylene Terephthalates; D011126:Polypropylenes