Early hemodynamic results of the Shelhigh SuperStentless aortic bioprostheses.
BACKGROUND
Stentless valves have been demonstrated excellent hemodynamic performances favoring the recovery of left ventricular function and the ventricular hypertrophy regression. The aim of the study was to evaluate the early hemodynamic performance of the Shelhigh SuperStentless aortic valve (AV).


METHODS
Between July 2003 and June 2005, 35 patients (18 females; age 70.8 +/- 11.7 years, range: 22-85) underwent AV replacement with the Shelhigh SuperStentless bioprostheses. Most recurrent etiology was senile degeneration in 25 (71%) patients and 24 (69%) were in New York Heart Association (NYHA) functional class III or IV. Concomitant coronary artery bypass grafting was performed in nine patients (25.7%) and mitral valve surgery in two patients (5.7%). Doppler echocardiography was performed before surgery, at six-month and one-year follow-up.


RESULTS
There were no hospital deaths and no valve-related perioperative complications. During one-year follow-up, no endocarditis or thromboembolic events were registered, no cases of structural dysfunction or valve thrombosis were noted. Mean and peak transvalvular gradients significantly decrease after AV replacement, with an evident reduction to approximately 50% of the preoperative values at six months. A 20% reduction was also observed for left ventricular mass (LVM) index at six months, with a further regression at one year. Correspondingly, significant increases in effective orifice area (EOA) and indexed EOA were determined after surgery (0.87 +/- 0.14 versus 1.84 +/- 0.29 cm2 and 0.54 +/- 0.19 versus 1.05 +/- 0.20 cm2/m2, respectively). Valve prosthesis-patient mismatch was moderate in five patients and severe in one case.


CONCLUSIONS
Shelhigh SuperStentless AV provided good and encouraging hemodynamic results. Long-term follow-up is necessary to evaluate late hemodynamic performance and durability of this stentless bioprosthesis.
Cattaneo
Paolo
P
Department of Cardiology and Cardiac Rehabilitation Clinical Institute Multimedica Holding Santa Maria, Castellanza, Varese, and Multimedica Sesto San Giovanni, Milano, Italy.
Bruno
Vito Domenico
VD
Mariscalco
Giovanni
G
Marchetti
Paolo
P
Ferrarese
Sandro
S
Salerno-Uriarte
Jorge
J
Sala
Andrea
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome