Early results of Bentall-type operations during the last 10 years: comparison of mechanical valves and stentless bioprostheses.
OBJECTIVE. Various types of prostheses have been used for combined diseases of the aortic root and ascending aorta.


METHODS
All Bentall-type operations (n=64) between 1996 and 2005 were retrospectively studied, comparing different types of prosthesis in the aortic position. The patients were 29-87 years old (mean 59.5 +/- 14.0 years) and included 47 men and 17 women. Mechanical valves, stentless bioprostheses (Freestyle), stented bioprostheses, and a homograft were used in 31, 29, 3, and I patients, respectively. Early results, especially hemodynamics, were analyzed among two groups: mechanical valve group (M-group) and Freestyle group (F-group).


RESULTS
The average age was significantly higher in the F-group (62.8 +/- 12.7 years) than in the M-group (54.9 +/- 14.0 years) (P = 0.025). The implanted valve was significantly larger in the F-group (26.0 +/- 2.3 mm) than in the M-group (23.5 +/- 2.1mm) (P = 0.000). The estimated effective orifice area of the prosthesis was significantly larger in the F-group (2.23 +/- 0.38 cm2) than in the M-group (1.84 +/- 0.49 cm2) (P = 0.001). The pressure gradient across the prosthesis was significantly lower in the F-group (18.6 +/- 5.5 mmHg) than in the M-group (25.4 +/- 7.6 mmHg) (P = 0.001).


CONCLUSIONS
The Bentall-type procedure using the Freestyle valve has an advantage regarding hemodynamics compared to the procedure employing mechanical prostheses.
Nakamura
Koki
K
Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Nemoto 473-1, Matsudo, Chiba 271-0077, Japan. kokinakamura@hotmail.com
Asai
Tomohiro
T
Murakami
Mikiko
M
Saitoh
Yosuke
Y
Yamaguchi
Hiroki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis / Q000639:trends*; D004867:Equipment Design; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000639:trends*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000639:trends*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012107:Research Design; D012189:Retrospective Studies; D012850:Sinus of Valsalva / Q000601:surgery; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography