title: Exercise echocardiography in cryopreserved aortic homografts: comparison of a prototype stentless, a stented bioprosthesis, and native aortic valves.
abstract: BACKGROUND
  Aortic valve replacement with a cryopreserved aortic homograft (CH) is an attractive alternative to bioprosthesis implantation. The aim of the study was to compare the hemodynamic performance of CH implanted with aortic root inclusion compared to prototype stentless (SS) bioprosthesis, standard stented (SD) bioprosthesis, and a native aortic valve.
  
  
  METHODS
  Hemodynamics and Doppler echocardiographic measurements such as left ventricular ejection fraction, aortic valve orifice area index (AVOAI), mean and maximal transvalvular gradients, were obtained at rest and immediately after exercise in 28 patients after aortic valve replacement with CH (n = 10), SS (n = 9), or SD (n = 9), and in a control group (CG) of 15 normal volunteers.
  
  
  RESULTS
  Rest and peak exercise heart rate and workload achieved were not different among the groups. Baseline AVOAI was larger for CH and CG compared to SS and SD groups (P < 0.05). Maximal and mean transvalvular pressure gradients at rest were lower for CH compared to SS and SD groups (P < 0.05), but higher than CG (P < 0,05).
  
  
  CONCLUSIONS
  Implanted aortic CH had better hemodynamic performance than SS and SD bioprosthesis and similar to native normal aortic valves, both at rest and immediately after exercise.
authors.affiliation: Federal University of São Paulo, Division of Cardiology (Echocardiography), Brasil. acordovil@ig.com.br
authors.forename: Adriana
authors.initials: A
authors.lastname: Cordovil
authors.forename: Orlando Campos
authors.initials: OC
authors.lastname: Filho
authors.forename: José Lázaro
authors.initials: JL
authors.lastname: de Andrade
authors.forename: Ana Clara Tude
authors.initials: AC
authors.lastname: Rodrigues
authors.forename: Luis Antonio
authors.initials: LA
authors.lastname: Gerola
authors.forename: Valdir
authors.initials: V
authors.lastname: Moises
authors.forename: Enio
authors.initials: E
authors.lastname: Buffolo
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: de Camargo Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000637:transplantation*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D015925:Cryopreservation / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography