title: Surgical outcome of stentless aortic valve replacement for calcified aortic stenosis.
abstract: We have conducted aortic valve replacement (AVR) using a stentless bioprosthesis (Medtronic Freestyle valve) on 10 patients with calcified aortic stenosis since March 2004. There were 64-84 years of age and 75 ± 5.5 years old on average, and included 4 males. Implantation was conducted by a modified subcoronary method in all the patients. The preoperative New York Heart Association class was class II in 80% of the patients. The preoperative left ventricular mass and the left ventricular mass index (LVMI) were 193.1-524.1 g and 144.1-299.5 g/m2 and, on average 328.4 ± 104.7 g and 217.3 ± 55.7 g/m2, respectively. The annulus dimension was 18-24 mm and, on average, 20.3 ± 1.7 mm. The size of implanted valve was 19-25 mm and, on average, 21 ± 2.2 mm. The maximum pressure gradient of the aortic valve remained at 14.2-46.5 mmHg, 25.2 ± 10.2 mmHg on average, 1 or 2 months after surgery, but the LVMI significantly improved to 153.2 ± 33.9 g/m2 (p = 0.018). The hospitalization period were 24.7 ± 16.9 days for all the patients and 19.3 ± 5.1 days for patients undergoing the AVR alone. These results show that LVMI is significantly reduced by using a stentless bioprosthesis in the early phase after surgery, and early discharge from hospital can be expected by concurrently using minimally invasive cardiac surgery.
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. ina-shun@is.icc.u-tokai.ac.jp.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Inamura
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Furuya
authors.forename: Kentarou
authors.initials: K
authors.lastname: Yagi
authors.forename: Eriko
authors.initials: E
authors.lastname: Ikeya
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Takabumi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kanabuchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000473:pathology* / Q000601:surgery*; D002114:Calcinosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016896:Treatment Outcome