Long-term follow-up of stentless prosthesis.
BACKGROUND
Stentless prostheses have an interesting hemodynamic performance when compared to stented prostheses and are recommended in cases of small aortic annulus.


METHODS
From January 1996 to January 2004, 138 patients suffering from aortic disease, underwent aortic valve replacement. • Group A: 93 patients underwent stentless aortic valve implantation [stentless Biocor (Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil) and stentless Sorin (Sorin Group, Saluggia, Italy)]. • Group B: 45 patients underwent stented aortic valve implantation (stented Biocor). Patients were assessed by clinical evaluation and echocardiography after a mean follow up of 124.5 ± 58.2 months.


RESULTS
There was a significant difference in terms of time of extracorporeal circulation and aortic cross clamp. The actuarial survival at 4, 8, 12, and 15 years is 77%, 50%, 21%, and 18%, respectively. Freedom from reoperation at 4, 8, 12, and 14 years was 92%, 83%, 73%, and 63%, respectively. Freedom from all events, death, and reoperation at 4, 8, 12, and 14 years was 70%, 39%, 13%, and 8%, respectively. There is no statistical difference among the two groups in terms of actuarial survival, freedom from reoperation, and freedom from re-hospitalization for prosthesis-related causes.


CONCLUSIONS
There was a significantly higher incidence of pacemaker implantation in Group A and the causes are not known. The rate of freedom from reoperation is high in both groups for the patients who remained alive. There was no statistical difference about prosthesis dysfunction between the two groups. The higher incidence of death in Group A cannot be explained by causes related to the prosthesis because there is no difference in terms of causes of death. Rates of reoperation did not differ between the two groups.


CONCLUSIONS
The results obtained with stentless prostheses are encouraging even in long-term follow-up.
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy. Electronic address: fabrisans@katamail.com.
Fabrizio
F
Sansone
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Guglielmo Mario Actis
GM
Dato
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Edoardo
E
Zingarelli
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Emanuele
E
Ferrero
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Sara
S
Prot
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Fabrizio
F
Ceresa
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Francesco
F
Patanè
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L. go Turati 62, 10135 Turin, Italy.
Riccardo
R
Casabona
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D003250:Constriction; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D015607:Stents; D015996:Survival Rate; D013997:Time Factors
Aortic valve; Long-term follow-up; Stented prosthesis; Stentless prosthesis