The Stentless Cryo-Life O'Brien porcine aortic valve at 10 years.
J Heart Valve Dis
; 13(6): 977-83; discussion 983, 2004 Nov.
Article
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| MEDLINE
| ID: mdl-15597593
ABSTRACT
BACKGROUND AND AIM OF THE STUDY If stentless devices--with their physiological advantages--are to remain attractive, their long-term durability must equate with that of reference stented valves. METHODS:
Between August 1991 and August 2001, 650 patients (mean age 72.0+/-4.2 years) received a Cryo-Life O'Brien Stentless aortic porcine bioprosthesis. The mean follow up was 4.6 years; total follow up was 2,644 patient-years (pt-yr). Among patients, 79% were in NYHA classes III-IV. Calcific aortic stenosis accounted for 93% of patients, who were predominantly female (75%), with associated coronary surgery in 19% and mitral surgery in 10.3%. Follow up was based on serial echocardiography, referring cardiologists' reports, and direct home telephone calls. Data were gathered over a six-month period.RESULTS:
Operative mortality was 8.1% (n = 51). Of these deaths, 2.7% were in isolated cases (mean age 72.0+/-4.2 years) and 14% with associated procedures (mean age 77.0+/-5.3 years). There were 103 late deaths (3.9% per pt-yr). Valve-related complications included 14 deaths (linearized rate 0.52% per pt-yr), reoperation in 22 (0.8% per pt-yr), eight operated valvular endocarditis (0.3% per pt-yr), two valve thrombosis (0.07% per pt-yr), 11 embolic events (0.3% per pt-yr), and 14 anticoagulant-related bleeding (0.52% per pt-yr). Actuarial survival was 76+/-6% at 10 years, with a freedom from structural deterioration of 99.75% in patients aged > or =65 years (mean age 76+/-8 years), and 86% in patients aged <65 years (mean age 44+/-15 years). The gradients remained low, and the echocardiographic aspect was close to that of a normal valve.CONCLUSION:
At 10 years, the Cryo-Life O'Brien Stentless provided excellent results in terms of durability associated with all the stentless advantages relating to physiology--gradients, orifice areas, and mass regression--that translate into an appropriately adapted left ventricular exertion profile.
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Banco de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
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Bioprótesis
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Prótesis Valvulares Cardíacas
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Stents
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Implantación de Prótesis de Válvulas Cardíacas
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2004
Tipo del documento:
Article