Early postoperative hemodynamic performances of stented versus stentless aortic xenografts in aortic valve replacement in elderly patients: a comparative study.

BACKGROUND AND AIM: Surgical valve replacement is the most commonly performed for aortic stenosis. Randomized trials comparing stentless to stented bioprostheses for aortic valve replacement in elderly are scarce. The aim of our study was comparing and evaluating the early hemodynamic performances of Hancock™ stented and FreeStyle™ stentless xenograft aortic valves in aortic valve replacement in elderly patients. PATIENTS AND METHODS: The study involved 40 patients (27 females and 13 males) older than 75 years old. The study was done during the postoperative period. Aortic valve replacements of stented and stentless xenografts were performed to the patients in Group I and Group II, respectively. Investigations for the echocardiographic results were completed on the postoperative 8-10th days. Parameters for the evaluation of hemodynamics were peak pressure gradient, mean pressure gradient and effective orifice area. The parameters were calculated with Doppler echocardiography by using specific formulas. RESULTS: Peak pressure gradients in patients with stented valves were significantly higher than in stentless valves [Stented valve group 32.45 ± 7.58 vs Stentless valve group 21.50 ± 4.77 mmHg] (p < 0.05). Mean pressure gradients were found to be significantly higher in stented group compared with stented group [Stented valve group 11.050 ± 3.2521 vs Stentless valve group 19.350 ± 6.6036 mmHg] (p < 0.05). The effective orifice area index of implanted valve was significantly greater in the stentless group, as well [Stentless valve group 2.5050 ± 0.6022 vs Stented valve group 1.3050 ± 0.3316 cm2] (p < 0.05). CONCLUSIONS: In early postoperative period, effective orifice areas and pressure gradients were found higher in stentless valve group.

Unusual localization of a primary hydatid cyst: a subcutaneous mass in the paraumbilical region.

Hydatid cyst disease caused by Echinoccus granulosus is not a rare disease and mostly localized in liver and lung. The localization of the disease in the subcutaneous paraumbilical region without any other organ involvement is a unique existence that we present. A 63-year-old Turkish male complaining of abdominal distention and pain had an abdominal mass for one year. When the patient came to our Clinic, we detected a 4x5 cm mass in the left quadrant- paraumbilical region by using ultrasonography. Complete surgical resection of the mass was performed with uneventful post-operative recovery. Histopathological examination of the surgical specimen demonstrated a multive-sicular hydatid cyst. When a subcutaneous cystic mass is detected in a patient, regarding the region where he lives and endemicity, hydatid cyst should be considered.